Fun Run Fun Cycling Race Bib Number:

PLAYER’S PROFILE
Buklod
Ecclesiastical District Local Congregation
KADIWA

Binhi

PERSONAL INFORMATION

Name

Address

Birthday Age Gender

CONTACT INFORMATION

Telegram Account (Username) Mobile Number

Contact Person In Case Of Emergency Local Congregation

Emergency Contact Number Relation

MEDICAL REQUIREMENTS

Health Concern
TMedical Related Request
 MEDICAL CERTIFICATE
(To be accomplished by a physician)

This is to certify that the participant is:

Fit to play (Specify Event)

Unfit to play (Specify Event)

Printed Name and Signature of Physician License Number