2019-2020 BCSD PE Waiver Intent Form
Students and Parents/Guardians,

EACH YEAR those students participating in the PE WAIVER option MUST complete a form.

Under legislation by the Ohio General Assembly, interscholastic sports, cheerleading, and after-school marching band may be used to fulfill the requirement for the physical education requirement for graduation.

In the Berea City Schools, only athletic programs sanctioned by the Ohio High School Athletic Association, cheerleading, and after-school marching band will be accepted for the PE Waiver.

High school students may request the opportunity to receive academic exemption for physical education by participating in any one of the above sanctioned activities in grades 9 -11.

Students MUST successfully complete the two season(s) in which they have elected to participate by the end of his/her JUNIOR year to qualify. Students complete the form using the @bereaschools.org email.

In order to facilitate accurate scheduling and record keeping, we require each student to fill out an exemption form as well as indicate PE Waiver on his/her course selection sheet annually.

This form must be completed by Saturday March 1st.

Email address *
1. CURRENT School *
Select your current school of enrollment when submitting this form.
2. Student Last Name *
Your answer
3. Student First Name *
Your answer
4. Student ID Number *
This is your school ID number.
Your answer
5. Parent/Guardian Last Name *
Your answer
6. Parent/Guardian First Name *
Your answer
7. Parent/Guardian Phone Number *
XXX-XXX-XXXX
Your answer
8. Expected High School Graduation Year *
Special note: Grade 10 students must complete 2 sanctioned activities by the end of his/her junior year.
9. I understand that I am able to satisfy the PE graduation requirement by successfully completing two full seasons of any combination of the following activities: any Berea City School's athletic programs sanctioned by the Ohio High School Athletic Association, cheerleading, and after-school marching band by the end of my junior year. *
In order to meet the high school PE graduation requirement, students MUST complete two full seasons of sanctioned activities or earn .50 credits of physical education course work. A student cannot do a combination of a PE "full season" exemption and high school physical education.
10. I understand that the waiver provides no actual Physical Education credit(s) on my high school transcript. *
11. I understand that the total number of credits required for graduation does not change, therefore, I need to replace physical education courses with other academic electives or simply take physical education as an elective. *
12. I understand that a coach and/or director must verify a season or year as completed successfully. (The exemption will be noted on the student's official transcript once both seasons are successfully completed.) *
13. I understand that a combination of a high school credit of one PE course combined with one activity or sport does not satisfy the requirement for a waiver. *
Berea City School District Sanctioned Options - Select Your Intent Below
In the Berea City Schools, only athletic programs sanctioned by the Ohio High School Athletic Association, cheerleading, and after-school marching band will be accepted for this educational option. A minimum of sixty hours in a sanctioned activity and successful completion of a full-season is required for a .25 credit to be granted. Select season 1 and 2 below.
15. Season 1 - Select the Season for the Sanctioned Program *
Select the season for Marching Band, Cheerleading and/or OHSAA Sport.
16. Season 1 - Select the Level of the Sanctioned Program *
17. Season 1 - Select the Sanctioned Program *
Select the Berea Sanctioned Program i.e., Marching Band, Cheerleading or OHSAA Sport.
18. Season 2 - Select the Season for the Sanctioned Program *
Select the Season for Marching Band, Cheerleading and/or OHSAA Sport.
19. Season 2 - Select the Level of the Sanctioned Program *
20. Season 2 - Select the Sanctioned Program *
Select the Berea Sanctioned Program i.e., Marching Band, Cheerleading or OHSAA Sport.
21. Student's EMAIL address *
Enter your bereaschools.org email address below.
Your answer
22. Parent's/Guardian's EMAIL address *
Enter the Parent's/Guardian's email address below.
Your answer
23. School Counselor *
Digital Signature (Required of Student and Parent/Guardian)
I(the student) and parent/guardian have agreed to submit this application by electronic means. By signing this application electronically, I/We certify under penalty of perjury and false swearing that my answers are correct and complete to the best of my knowledge.
STUDENT DIGITAL SIGNATURE *
Enter your first and last name
Your answer
PARENT/GUARDIAN DIGITAL SIGNATURE *
Enter your first and last name
Your answer
A copy of your responses will be emailed to the address you provided.
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