My high school had a swimming requirement. We selected the units we wanted to take from a wide variety of things but one of those units had to be swimming. They even provided the swimsuits. Sophomores and juniors also had to take one unit of square dancing, ballroom dance, and polka (which was really fun). After swimming and dance, you could pick from traditional things like volleyball and basketball, but also curling, bowling, golf, archery, and gymnastics.
No one was exempt from PE. If you couldn’t participate in sports or games, they’d find something for you to do. Every unit had a written test and you could grade the tests, pick up equipment, be a timer, have someone help you with the sport. Even those with broken bones and a cast still had to go to Gym, but they could put off the swimming requirement.