Revised as of FEBRUARY 8, 2024 VII

REGION
BOHOL
DIVISION

TENNIS ELEMENTARY GIRLS

EVENT

A. COACH/ASST. COACH RECORD

B. APPOINTMENT/EMPLOYMENT/CONTRACT OF SERVICE
C. OMNIBUS AFFIDAVIT
D. MEDICAL CERTIFICATE
E CERTIFICATE OF TRAINING

CERTIFICATE OF SPORTS MEMBERSHIP/ LICENSE OR CERTIFICATIONS/

F
ACCREDITATION

PALMA, ANALIZA P.
COACH
PALMA , ANALIZA P. NAME
TABALONG ELEMENTARY SCHOOL SCHOOL

A. APPOINTMENT/EMPLOYMENT/CONTRACT OF SERVICE
B. CERTIFICATE OF COMMITMENT
C. MEDICAL CERTIFICATE

Chaperon

NAME
SCHOOL

A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE (for Palarong Pambansa Only)
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY

F. MEDICAL CERTIFICATE
Athlete
G. DENTAL CERTIFICATE
H. DISABILITY ASSESSMENT (for PARAGAMES Only) OPALLA, MARY REIGN S.
INTERVIEWED GRADE - V
AMOTO , MARJORIE L. NAME OF ATHLETE OPALLA , MARY REIGN S.
117953170031 LRN 118556180077
OCTOBER 03, 2011 JUNE 04 , 2014
ANDA CENTRAL ELEMENTARY SCHOOL SCHOOL DANAO ELEMETARY SCHOOL

A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE (for Palarong Pambansa Only)
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
Athlete F. MEDICAL CERTIFICATE
Athlete
G. DENTAL CERTIFICATE
H. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED

BEROU , LADY ARIANNA A. NAME OF ATHLETE VILLARIAS , NIÑA ZULEIKHA I.

117955170011 LRN 118713170195
DECEMBER 04 , 2011 DATE OF BIRTH MAY 22 , 2012
ANDA CENTRAL ELEMENTARY SCHOOL SCHOOL MARIVELES ELEMENARY SCHOOL

NOTE:
PLEASE USE A4 SIZE COPY PAPER
FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)
 A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE (for Palarong Pambansa Only)
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
Athlete F. MEDICAL CERTIFICATE
Athlete
G. DENTAL CERTIFICATE
H. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED

NAME OF ATHLETE
LRN
DATE OF BIRTH
SCHOOL

A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE (for Palarong Pambansa Only)
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
Athlete F. MEDICAL CERTIFICATE
Athlete
G. DENTAL CERTIFICATE
H. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED

NAME OF ATHLETE
LRN
DATE OF BIRTH
SCHOOL
A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE (for Palarong Pambansa Only)
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
Athlete F. MEDICAL CERTIFICATE
Athlete
G. DENTAL CERTIFICATE
H. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED

NAME OF ATHLETE
LRN
DATE OF BIRTH
SCHOOL

A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE (for Palarong Pambansa Only)
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
Athlete F. MEDICAL CERTIFICATE
Athlete
G. DENTAL CERTIFICATE
H. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED

NAME OF ATHLETE
LRN
DATE OF BIRTH
SCHOOL

NOTE:
PLEASE USE A4 SIZE COPY PAPER
FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)
OPALLA, MARY REIGN S.
GRADE - V