In our district a physical (no more than a year old) is required when a child enters Kindergarten, and then again in 7th grade, and if a student is entering from a different district. A yearly physical is also required if a student wishes to play a sport. If you cannot afford a physical, you are referred to a clinic which provides them free or very low cost. Our schools also require dental screenings and vision screenings (if you don't have one, the school does it for you). Our local preschools provide free dental screenings and vision screenings so most children have completed the process prior to entering Kindergarten.
Once a student enters 6th grade, they have to sign a "physical activity contract" which states that a student must engage in a minimum of 120 minutes of physical activity during school weeks. They have to indicate how they will do so (basketball, soccer, yard work, etc.).