VII

REGION
ELEMENTARY
LEVEL
BASEBALL
EVENT

CACR (COACH /ASST.COACH RECORD)

CERTIFICATE OF EMPLOYMENT

APPOINTMENT (PUBLIC) / CONTRACT OF SERVICE ( PRIVATE)

OMNIBUS AFFIDAVIT
COACH PERSONAL DATA SHEET ASST. COACH
MEDICAL CERTIFICATE
CERTIFICATE OF TRAINING
CERTIFICATE OF SPORTS MEMBERSHIP
CERT. OF SPORTS RECOGNITION IN LOWER MEETS

NAME
SCHOOL
DATE OF BIRTH
CONTACT NUMBER

PERSONAL DATA SHEET

MEDICAL CERTIFICATE

CERTIFICATE OF COMMITMENT

CHAPERON

NAME
SCHOOL
DATE OF BIRTH
CONTACT NUMBER

ATHLETE'S RECORD
ORIGINAL PSA BIRTH CERTIFICATE
SF 10 / FORM 137

CERTIFICATE OF ENROLMENT AND ATTENDANCE/COMPLETION

ATHLETE1 PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & ATHLETE 3

CUSTODY

MEDICAL CERTIFICATE
DISABILITY ASSESSMENT (for PARAGAMES only)
INTERVIEWED

xxxxxxx NAME OF ATHLETE

june 14, 2010 DATE OF BIRTH
school SCHOOL
LEARNERS REFERENCE NUMBER (LRN)
CONTACT NUMBER

ATHLETE'S RECORD
ORIGINAL PSA BIRTH CERTIFICATE
SF 10

CERTIFICATE OF ENROLMENT AND ATTENDANCE/COMPLETION

ATHLETE 2 PARENTAL CONSENT ATHLETE 4

MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED

NAME OF ATHLETE
DATE OF BIRTH
SCHOOL
LEARNERS REFERENCE NUMBER (LRN)
CONTACT NUMBER
 REGION

LEVEL

EVENT
ATHLETE'S RECORD
ORIGINAL PSA BIRTH CERTIFICATE
SF 10

CERTIFICATE OF ENROLMENT AND ATTENDANCE/COMPLETION

PARENTAL CONSENT
ATHLETE 5 ATHLETE 9
MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED

NAME OF ATHLETE
DATE OF BIRTH
SCHOOL
LEARNERS REFERENCE NUMBER (LRN)
CONTACT NUMBER

ATHLETE'S RECORD
ORIGINAL PSA BIRTH CERTIFICATE
SF 10

CERTIFICATE OF ENROLMENT AND ATTENDANCE/COMPLETION

PARENTAL CONSENT
ATHLETE 6 ATHLETE 10
MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED

NAME OF ATHLETE
DATE OF BIRTH
SCHOOL
LEARNERS REFERENCE NUMBER (LRN)
CONTACT NUMBER

ATHLETE'S RECORD
ORIGINAL PSA BIRTH CERTIFICATE
SF 10

CERTIFICATE OF ENROLMENT AND ATTENDANCE/COMPLETION

PARENTAL CONSENT
ATHLETE 7 ATHLETE 11
MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED

NAME OF ATHLETE
DATE OF BIRTH
SCHOOL
LEARNERS REFERENCE NUMBER (LRN)
CONTACT NUMBER
ATHLETE'S RECORD
ORIGINAL PSA BIRTH CERTIFICATE
SF 10

CERTIFICATE OF ENROLMENT AND ATTENDANCE/COMPLETION

PARENTAL CONSENT
ATHLETE 8 ATHLETE 12
MEDICAL CERTIFICATE
DENTAL CERTIFICATE
INTERVIEWED

NAME OF ATHLETE
DATE OF BIRTH
SCHOOL
LEARNERS REFERENCE NUMBER (LRN)
CONTACT NUMBER
 VII
REGION
SECONDARY
LEVEL
TABLE TENNIS BOYS
EVENT

CACR (COACH /ASST.COACH RECORD)

CERTIFICATE OF EMPLOYMENT

APPOINTMENT (PUBLIC) / CONTRACT OF SERVICE ( PRIVATE)

OMNIBUS AFFIDAVIT
COACH PERSONAL DATA SHEET
MEDICAL CERTIFICATE
CERTIFICATE OF TRAINING

CERT. OF SPORTS RECOGNITION IN LOWER MEETS

PINGOL, MARGARITA D. NAME

USJR SCHOOL
12/08/1998 DATE OF BIRTH
9452940179 CONTACT NUMBER

PERSONAL DATA SHEET

MEDICAL CERTIFICATE

CERTIFICATE OF COMMITMENT

CHAPERON

NAME
SCHOOL
DATE OF BIRTH
CONTACT NUMBER

ATHLETE'S RECORD
ORIGINAL PSA BIRTH CERTIFICATE
SF 10 / FORM 137

CERTIFICATE OF ENROLMENT AND ATTENDANCE/COMPLETION

PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & ATHLETE 3

CUSTODY

MEDICAL CERTIFICATE
DENTAL CERTIFICATE
DISABILITY ASSESSMENT (for PARAGAMES only)
INTERVIEWED
CUEVAS, GIANCARLO TIMOTHY N. NAME OF ATHLETE ONDOY, BRETH SCHULZ S.
10/03/2011 DATE OF BIRTH 08/14/2008
USJR SCHOOL USJR
447087160014 LEARNERS REFERENCE NUMBER (LRN) 119824140331
CONTACT NUMBER

ATHLETE'S RECORD
ORIGINAL PSA BIRTH CERTIFICATE
SF 10 / FORM 137

CERTIFICATE OF ENROLMENT AND ATTENDANCE/COMPLETION

ATHLETE 2 PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & ATHLETE 4

CUSTODY

MEDICAL CERTIFICATE
DENTAL CERTIFICATE
DISABILITY ASSESSMENT (for PARAGAMES only)
INTERVIEWED
LAPENING, REY EMMANUEL A. NAME OF ATHLETE SURIGAO, MARKENT IVAN M.
01/21/2011 DATE OF BIRTH 04/15/2012
USJR SCHOOL USJR
404301160003 LEARNERS REFERENCE NUMBER (LRN) 120757170043
CONTACT NUMBER