RICHARDSON INDEPENDENT SCHOOL DISTRICT
2017-2018 Off-Campus Physical Education
Instructor Agreement
(Sign and return)
Instructor’s Name
Agency
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Student Name
As a professional instructor, I am aware of the emphasis on program objectives, grading based on
performance and attendance established by public education and Richardson Independent School
District. I understand the problems inherent in a program such a Off- Campus Physical Education and
the importance of maintaining program integrity. Therefore, I will support the following conditions to my
certification as an Off-Campus Physical Education instructor.
1. The instructor will adhere to the district’s guidelines for attendance / behavior by the student.
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The student must participate in his/her activity, under professional supervision, a minimum of
ten hours each week at one agency. Students who are receiving a release period from school
must attend a minimum of fifteen hours at the agency.
The required ten/fifteen hours each week must be spread over at least four days and include at
least ninety minutes of instruction by one approved instructor.
At least five of the required hours each week must be completed Monday through Friday.
A maximum of two of the ten/fifteen required hours each week may be accounted for in
competitive meets/tournaments. (Ice skaters may not include more than four hours in public
session skating.)
2. The instructor will keep an accurate record of student attendance. The instructor will contact the
Off-Campus Physical Education Coordinator at 972 571-4175 if a student’s attendance
becomes irregular.
3. Agencies must provide a clean and safe environment in which students are “well supervised,”
meaning the instructor must be present at all times during the scheduled activity to provide
guidance, instruction and to ensure safety.
4. The instructor will forward a grade recommendation based on student performance on the
following dates: (grades must be sent in a timely manner)
(Dates will be provided to the instructor / Agency by PE Department)
5. The instructor must be available to turn in grades in a timely manner. If the instructor is not able
to turn in grades he/she must have them provided through his/her agency. Please note that if
grades are not provided this may cause termination of your agency to participate in the RISD
Off-Campus PE program.
6. I understand that the Richardson Independent School District is accountable for the participation
of each student in Off-campus Physical Education. I will make every effort to cooperate with the
district in their accounting procedures. Please sign and MAIL this form along with the
student application to 701 W. Belt Line Rd. Richardson, TX 75080, attn Carol Mathews.
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Instructor’s Signature
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Date