Department of Education

Region IV-A CALABARZON

DIVISION OF BATANGAS

Event: TAEKWONDO GIRLS ELEMENTARY ( ) Secondary (/ ) Elementary ( ) Boys (/ ) Girls

AR 1 (Athlete Record) NSO Birth Cert. FORM 137 Parental Consent

Date of Birth Gr/Yr Cert. of
No. Name of Athletes Age (YY-
Enrolmen Teacher School Medical Dental Remarks
MM-DD) Level PESS Photo Tea. School Div. PESS
(YY-MM-DD)
Ath Coach Original t
Coor copy Adviser Head Supervisor Adviser Head

1 MARY AMBER G. BADDONGON 11/09/09 12/03/22 VI

JESSA D. MANGAOIT
Screening Representative Signature of Coach Over Printed Name