Republic of the Philippines

Department of Education
Region I
Schools Division Office I Pangasinan

CHECKLIST OF REQUIREMENTS FOR DIVISION MEET 2023

NAME OF SCHOOL:

EVENT: ATHLETES COACH/ASSISTANT COACH

GOA AR BIRTH MEDICAL MED SF10 PC/SS CO OMNIBUS MED CONTRACT COT
INSURANCE AFFIDAVIT CERT
CERT CERT HISTORY A
NAME OF ATHLETES/COACH
ATHLETE COAC
H
1. Delos Santos, Renz Ivan
2. Manangan, Steve Nash P.
3. Biaco, Dustine John DS.
4. Padilla, Daniel Luis
5. Evangelista, Geraldo M.
6. Majaba, John Cris P.
7. Castro, Gilbert Jr. G.
8. Cagunot, Jayferson C.
9. Villacorta, Alexis John A.
10. Ebo, Jhon Adrian F.
11. De Ocampo, Renshin Kylle F.
12. Rosario, Leonard S.
COACH/ASSISTANT COACH
1.
2.
3.

1. GoA- Gallery of Athletes (Name, LRN, Birthdate, Picture w/ Name tag) 7. Parental Consent/ Sworn Statement
2. Athletic Record (AR) w/ picture 8. Certificate of Attendance
3. PSA/ Live Birth Certificate (Certified by the School Head) 9. Insurance
4. Medical Certificate of Athletes 10. Medical Certificate of Coaches
5. Medical History 11. Appointment/ Contract
6. SF10/ Form 137 12. Certificate of Training of Coaches
SCREENING COMMITTEE

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