Catholic Educational Association of the Philippines

CEAP Mindanao Games 2024

ATHLETE’S PERSONAL DATA

Name: ______________________________________________________________________
Last Name First Name Middle Name

Date of Birth: ___________________ Age: ___________ Place of Birth: _______________

Home Address: _______________________________________________________________
School: ______________________________________________________________________
Name of Parents: _________________________________ ____________________________
(Father) (Mother)
Address of Parents: ____________________________________________________________

_____________________________
Signature of Athlete

This is to certify that I have verified the personal records of the above-mentioned athlete and
found the same to be true and correct.

_____________________________________ ___________________________________
Sports Coordinator Coach

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MEDICAL CERTIFICATE

Date: __________________
TO WHOM IT MAY CONCERN:
This is to certify that ______________________________________ has been
thoroughly examined by me and that he/she is not suffering from weak of heart, defective lungs,
or some communicable disease that will endanger his/her health or the health of other people.
He/she is therefore physically and mentally fit to participate in the CEAP MINDANAO
GAMES for the school year 2023-2024.

__________________________________
(Signature over Printed Name of Physician)
License: __________________________
Date: ____________________________

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PARENT/GUARDIAN CONSENT

_____________________
Date

TO WHOM IT MAY CONCERN:

This is to expressly allow my son/daughter _________________________________ to

participate in the CEAP MINDANAO GAMES for the school year 2023-2024.
Aware that such athletic activities are in accord with the school’s and CEAP sports
program, and aware that the coaches and other athletic officials will exercise utmost care and
precaution during the said activities, I shall not hold the management conducting CEAP
MINDANAO GAMES liable of any untoward incidents that may happen that is beyond their
control. That I am giving my consent willingly.

__________________________________
(Signature of Parents/Guardian over Printed Name)