Ventura Unified School District Independent Study Physical Education Program (ISPE)

Transcription

1 To: Parent/Guardian Ventura Unified School District Independent Study Physical Education Program (ISPE) Attached is information regarding the Independent Study Physical Education Program. In order for a student to participate in this program, the following criteria must be met: The student must have received physical education credit with a grade of C or better for the one semester or two quarters preceding the period for which the original request is made and must maintain an overall 2.0 grade point average to continue in the Independent Study Physical Education Program (Administration Regulation ). Independent Study Physical Education must develop proficiency, knowledge, and skills beyond that which can be achieved within an in-school program (Administration Regulation ). After the first semester, renewal for any subsequent semesters will be based on satisfactory progress in the categories described in these criteria (Administration Regulation ). The time spent in instruction must total not less than 400 minutes every 10 school days. (California Education Code 51222). (400 minutes = 6 hours, 40 minutes). Independent Study Physical Education must continue for a complete semester or year (Administration Regulation ). All students enrolled in independent study physical education are required to take state mandated physical education fitness tests administered and completed under the supervision of district physical education credentialed personnel before independent study physical education credit can be given (Administration Regulation ). Please complete the following forms: Checklist Form To be completed by the parent/guardian. Complete the Student Information at the top of the form. Contract Form To be completed by the parent/guardian and signed by the student, parent/guardian, ISPE instructor, student s counselor and the school site supervisor in charge of the ISPE program. Instructor Verification Form To be completed and signed by the ISPE Instructor providing the physical education. Hold Harmless Agreement Form To be completed and signed by the parent/guardian. The signature of a representative from the organization providing the physical education must also appear on this form.

2 Monthly Attendance Report Form The parent/guardian gives this form to the organization providing the physical education. The instructor for the ISPE program completes this form on a monthly basis and returns it to the counseling office at the school the student is attending. PLEASE NOTE: STUDENT WILL RECEIVE A PASS OR FAIL GRADE AS INDICATED IN THE BOARD POLICY The district requires that a Certificate of Insurance be supplied by the organization providing the physical education. This Certificate of Insurance will have $300, combined single limit coverage for personal injury or property damage and will name Ventura Unified School District as additional insured. It is the responsibility of the parent/guardian to request this certificate from the organization. Current independent study physical education programs insurance coverage is posted on the Ventura Unified School District website. Submit this application package to the counseling office at the school your child is attending. Please Note: This application package must be submitted and all requirements met on an annual basis.

3 Ventura Unified School District INDEPENDENT STUDY PHYSICAL EDUCATION (ISPE) Checklist Today s Student Name: Address: Name of School: Address: Physical Activity: Phone: School Year: Grade (current): Please complete and return the following forms (the forms listed below are included in this packet, with the exception of the Certificate of Insurance which is obtained from the organization providing the Independent Study Physical Education): Please Note: This application package must be submitted and all requirements met on an annual basis. 1. Independent Study Checklist (this form). 2. Independent Study P.E. Contract. 3. Instructor Verification. 4. Hold Harmless Agreement signed by parent/guardian and ISPE program representative providing the Independent Study P.E. 5. Certificate of Insurance from the ISPE program of $300, combined single limit coverage for personal injury or property damage. The Certificate of Insurance must name Ventura Unified School District as additional insured. Current independent study physical education programs insurance coverage is posted on the Ventura Unified School District website. 6. Monthly Attendance Report completed by the ISPE program on a monthly basis. Comments:

4 Ventura Unified School District INDEPENDENT STUDY PHYSICAL EDUCATION (ISPE) Contract Student Name: Address: Parent/Guardian Name(s): Home Phone: Work Phone: FITNESS ORGANIZATION INFORMATION Name of ISPE Program: Address of ISPE Program: Phone No. of ISPE Program: Name ISPE Instructor/Coach: Description of type of physical activities: Proposed schedule and time(s): Student s Signature: Parent/Guardian s Signature: ISPE Instructor s Signature: Counselor s Signature: Supervisor in Charge of ISPE Program at the school site: Criteria to participate in Independent Study P.E.: The time spent in instruction must total not less than 400 minutes each 10 schooldays (California Education Code 51222). ************************************************************************************ FOR DISTRICT USE ONLY Approved: Not Approved Signature of Principal

5 Ventura Unified School District INDEPENDENT STUDY PHYSICAL EDUCATION (ISPE) Instructor Verification (Off-Campus Instructor) Student s Name: Dear ISPE Instructor/Coach: Please describe your training and/or experience in the area(s) for which you will be instructing/coaching this student. In order for Ventura Unified School District students to earn physical education credits towards their high school diploma, the ISPE program and person responsible for the selected course must meet the following conditions: A current Hold Harmless Agreement and a Certificate of Insurance* must be submitted to Ventura Unified School District. (*must be for $300,000 combined single limit coverage for personal injury or property damage and must name Ventura Unified School District as additional insured.) Assumption of responsibility for the quality of instruction. Verification of dates of instruction and hours or participation (see monthly attendance report attached) Agreement to provide sufficient immediate supervision in order to prevent accidents and injuries. Evaluation of student s participation and progress toward meeting course objectives. ISPE Instructor s Signature: Name of Program providing Independent Study P.E.: Physical Activity:

6 Ventura Unified School District INDEPENDENT STUDY PHYSICAL EDUCATION Student/Participant Hold Harmless Agreement By signing this agreement, I agree to release and hold harmless Ventura Unified School District, its schools, their administrators, officers, board members, agents, teachers, volunteers, independent contractors and other employees and staff members, free and harmless from and against any and all liability, claims, demands, causes of action at law or equity, expenses and costs, including attorneys fees, or loss of any kind due to personal injury, including death, and/or property damage which may arise during or be caused in any way arising from the participation of my child in any and all classes or activities while enrolled in the Independent Study Physical Education Program including transportation of the Student/Participant to and from such classes or activities whether by walking, public carrier, private vehicle or any other mode of transportation. Name of Student/Participant School of Attendance In the event of injury or illness to my child, I hereby consent to whatever transportation, x-ray, examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care from a licensed physician as deemed necessary for the safety and welfare of my child. It is understood that any resulting expenses will be the responsibility of the parent(s)/legal guardian(s) of the Student/Participant. I agree that this agreement is intended to be as broad and inclusive as is permitted by the laws of the State of California. I have carefully read this Hold Harmless Agreement and fully understand its contents and voluntarily agree to its terms and conditions. I also understand that no Student/Participant will be allowed to participate and receive credit for Independent Study Physical Education without having a signed and legally valid Hold Harmless Agreement on file with the School/District. Executed on (date): by Name of Parent/Legal Guardian: At (city): California Signature of Parent/Legal Guardian:

7 Ventura Unified School District INDEPENDENT STUDY PHYSICAL EDUCATION (ISPE) Monthly Attendance Report Today s Name of Student: Home School: Name of ISPE Program: Address of ISPE Program: Phone Number of ISPE Program: Name of ISPE Instructor: School Year: Grade: (Please note that student s grades are reported as pass or fail, not a letter grade. Please indicate by placing an X by the correct designation. Pass: Fail: Reporting Month/Year: The time spent in instruction must total not less than 400 minutes every 10 school days. Instructor s Signature: Return this form monthly to the counseling office at the school the student is attending.

8 Ventura USD Administrative Regulation Independent Study Program Physical Education AR Instruction The district will allow students to be exempted from regular physical education classes if they are participating in district approved independent study physical education program. Criteria and Eligibility Independent study physical education is to be taken from a district approved school or program with professionally trained and experienced personnel. Activities that are not acceptable for independent study physical education are posted on the Ventura Unified School District website. Applicants must have received physical education credit with a grade of C or better for the one semester or two quarters preceeding the period for which the original request is made and must maintain an overall 2.0 grade point average to continue in the independent study physical education program. Incoming 6 th grade students must have received a level of proficient or mastery in physical education. Independent Study Physical Education must develop proficiency, knowledge, and skills beyond that which can be achieved within an in-school program. Students in grades 9 through 12 may use the independent study physical education exemption to meet a portion or all of their physical education graduation requirements of four semesters. After the first semester, renewal for any subsequent semesters will be based on satisfactory progress. The time spent in instruction must total not less than 400 minutes every each 10 school days. Independent study physical education must continue for a complete semester or year. A contract between the activity participant and his/her home school must be completed and include the following: * A schedule and location(s) of the off-campus independent study physical education program. * The method for evaluation of the objectives. * The duration of the contract. * The manner, time, and place of reporting student progress and attendance.

9 * The signature of the professional certified instructor of the independent study physical education program who will be assisting the student. * The signature of the student and parent(s)/guardian(s). * The signature of the principal. * The signature of the counselor. * The signature of the school site supervisor in charge of the independent study physical education program. Students enrolled in Independent Study Physical Education may receive a letter grade or a pass/fail grade to be determined by the school site supervisor in charge of the independent study physical education program and approved by the school site principal. All students enrolled in independent study physical education are required to take state mandated physical education fitness tests administered and completed under the supervision of district physical education credentialed personnel before independent study physical education credit can be given. Independent Study Physical Education Programs All programs must be approved through the Ventura Unified School District independent study physical education application process. The independent study physical education program must include with the independent study physical education application their assumption of responsibility for the quality of instruction, verification of dates of instruction and hours of participation, immediate supervision of the student, and evaluation of the student's performance and progress. Independent study physical education programs and their instructors must be willing to cooperate fully with the district in the conduct of the program. All independent study physical education programs must provide and maintain current proof of insurance coverage per district criteria. Current independent study physical education programs insurance coverage is posted on the Ventura Unified School District website. Student Procedures The independent study physical education forms will be completed and signed by the student, parent/guardian, the instructor of the independent study physical education program school site supervisor in charge of the independent study physical education program. The form will be signed and approved by the principal or designee. After the independent study physical education forms are completed and signed, it shall be distributed as follows:

10 * Original in the cumulative file of the student. * A copy to the parents/guardians. Appeal of Denial of Independent Study Physical Education The appeal shall be made in writing to the Superintendent or designee. The Superintendent or designee shall review the appeal and make a decision whether the request is appropriate. Transportation and Other Costs Transportation of the student to and from the independent study physical education program is the responsibility of the student and parent/guardian. The district will not be expected to provide any instructional supplies, textbooks, equipment, or other materials for the independent study physical education program and/or activities. There will be no cost incurred to the district for a student's participation in any programs covered by these regulations. Regulation VENTURA UNIFIED SCHOOL DISTRICT Approved: May 12, 2015 Ventura, California