Republic of the Philippines

DEPARTMENT OF EDUCATION
02
(Region)
CAUAYAN CITY
(Division)
Cauayan City, National High School
(School)
Turayong Cauayan City, Isabela
(School Address)

CERTIFICATE OF COMPLETION
Date: October 29, 2018
`
To Whom It May Concern:

This is to certify that Judy L. Barangay Jr. has completed the Grade- 12 H.E A
Secondary Level for the School Year 2018-2019.
.

JOHN R. MINA
Secondary School Principal IV
(Signature Over Printed Name)

FOR PALARONG PAMBANSA ONLY

 Republic of the Philippines
DEPARTMENT OF EDUCATION
02
(Region)
CAUAYAN CITY
(Division
Cauayan City, National High School
(School)
Turayong Cauayan City, Isabela
(School Address)

CERTIFICATE OF ENROLMENT
Date: June 10, 2018
`
To Whom It May Concern:

This is to certify that Judy L. Barangay Jr. has been enrolled for the School Year 2017-
2018.

CAROLYN G. ALIBANIA
Teacher-Adviser
(Signature over printed name)

Certified true and correct:

JOHN R. MINA
Secondary School Principal IV
(Signature over printed name)

FOR PALARONG PAMBANSA ONLY

 Republic of the Philippines
DEPARTMENT OF EDUCATION
02
(Region)
CAUAYAN CITY
(Division)
Cauayan City, National High School
(School)
Turayong Cauayan City, Isabela
(School Address)

MEDICAL CERTIFICATE
__________________
(Date)

To Whom It May Concern:

This is to certify that I have personally examined Judy L. Barangay Jr. age _17 sex
Name
_Male__born on June 18, 2001 and have found that he/she is physically fit, during the time of

examination, to join and compete in the lower meets and Palarong Pambansa.

Event: Athletics-Runs Boys

Physical Examination

Date examined: _______________

Height Weight: Blood Pressure
Pulse, Resting Respiratory Rate
Other Remarks:

____________________________
Physician/Medical Officer
(Signature over printed name)

License No. __________________

PTR.: ____________________
Date: ____________________

FOR PALARONG PAMBANSA ONLY

 Republic of the Philippines
DEPARTMENT OF EDUCATION
02
(Region)
CAUAYAN CITY
(Division)
Cauayan City, National High School
(School)
Turayong Cauayan City,Isabela
(School Address)

November 4, 2018
Date

P A R E N TA L C O N S E N T

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter JUDY L. BARANGAY JR. . in the Division, Regional Meet and Palarong
Pambansa.

I have considered the benefits that my son or daughter will derive from his/her
participation in this activity provided that due care and precaution will be observed to ensure the
comfort and safety of my son/daughter and that DepED employees and personnel may not be
held responsible for any untoward incident that may happen beyond their control.

Signature of Father Signature of Mother

JUDY F. BARANGAY SR. NORA L. BARANGAY

Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

CAROLYN G. ALIBANIA
Teacher-Adviser/School Head/Registrar

Remarks:

FOR PALARONG PAMBANSA ONLY