INTER COLLEGE TEAM COMPETITION

REGISTRATION FORM 2X2 Picture

A. PERSONAL INFORMATION:
Name : ________________________________________Date Of Registration:_____________________

Year And Course :______________________________ Student Number: _________________________

Complete Mailing Address ______________________________________________________________

Contact Number: ________________________________________ Email Address:_________________

INTERESTED IN VOLUNTEERING

o Match Referee
o Operate Score Board
B.EMERGENCY CONTACT & HEALTH INSURANCE INFORMATION

Emergency Contact’s Name : ______________________________ Relation: ______________________

Phone number : ___________________________________ Email Address: _______________________

Do you have health Insurance ? ( )Yes ( ) No

Philhealth member : ( ) Yes ( ) No

If below 21, are you a dependent of your Parent(s) philhealth? ( )Yes ( ) No

Do you have any allergies , chronic illness or medical conditions that hinder you in playing in the team
sports particularly in Basketball ? Volleyball? ( )YES ( ) NO

Others : ( ) Singing ( ) Dancing ( ) Cosplay ( ) Battle of the Brains ( ) Online game

If yes, kindly specify .

_____________________________________________________________________
_____________________________________________________________________

I attest that I am physically fit and have no symptoms of cough, fever, diarrhea, loss of taste or smell, sore
throat, headache, aches and pains.

Signature Over Printed Name of Player

Date : __________________________

Endorsed by: Approved by :

MS. OLLIE MARQUEZ MR.GILBERT T. SALVADOR

Campus Nurse Antipolo Campus Chair, Sports Committee
Date : ____________________ Date: ______________________
 PARENTS’ CONSENT

Although the safety of all sport activities is the primary concern in the following competitions ;
singing , dance and cosplay competition and outdoor sport activities at WCC Antipolo Campus , I
fully understand that this activity inside/outside the school is an integral part of the curriculum,
under the course that my child is enrolled in.

I understand the objective/s and rationale of this activity and I have the option clarify the details
before giving my consent.

I allow him/her to participate in the activities as I am aware of the health and safety protocols that he/she
must comply with and that the threat of COVID-19 is still around us. I also confirm that my child is
physically fit to safely participate in the activities and so thus, we have him/her covered of our Philhealth /
HMO. We do understand that in participating in this event he/she will be exposed to other people upon
his/her travel to school and we will not hold the school liable for any illnesses or untoward incident that our
child may encounter on the said event.

I am affixing my signature on the space provided below signifying my contest for my child to
participate in the above mentioned activity.

________________________________________
Signature over Printed name of Parents/Guardian

Date : _____________________

Contact Number : ___________________________Email Address: _____________________

House Address: ________________________________________________________________

MR.GILBERT T. SALVADOR
Chair, Sports Committee
Date: ______________________

Requirements :
 Bona fide College student Of World Citi Colleges
 Must be fully vaccinated
 Must have no symptoms of cough, colds, sore throat and diarrhea one week prior to the scheduled
game
 Physically Fit
 Vaccination Card – photo copy
 Health Declaration
 Registration Form