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Revised as of September 26, 2019 MIMAROPA

REGION
ORIENTAL MINDORO
DIVISION

SOFTBALL
EVENT

COACH/ASST. COACH RECORD


A. (CERTIFICATE OF TRAINING, RELEVANT COACHING EXPERIENCE )
B. APPOINTMENT (PUBLIC) / CONTRACT OF SERVICE (PRIVATE)
C. OMNIBUS AFFIDAVIT
Coach D. MEDICAL CERTIFICATE Assistant Coach

LIMUEL C. CARINGAL REXSON H. DE VILLA


Teacher I Teacher II

LIMUEL C. CARINGAL NAME REXSON H. DE VILLA


AURORA NHS- MALVAR EXT. SCHOOL AURORA NHS

A. CERTIFICATE OF COMMITMENT
B. MEDICAL CERTIFICATE

Chaperon

LENGEL F. GONITO
Teacher I

LENGEL F. GONITO NAME


AURORA NHS- MALVAR EXT. SCHOOL

A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
athlete F. MEDICAL CERTIFICATE
athlete
G. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED
MA CARLOTA G. PEREZ HECIEL JOY R. GATCHALIAN
Grade 12 Grade 11

MA CARLOTA G. PEREZ NAME OF ATHLETE HECIEL JOY R. GATCHALIAN


111538100053 LRN 110517100013
05/18/2005 DATE OF BIRTH 11/2/2005
AURORA NHS- MALVAR EXT. SCHOOL AURORA NHS- MALVAR EXT.

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. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED
RAYLENE M. CARPIO
Grade 10 ESTEPHANIE R. ENANO
Grade 10

RAYLANE M. CARPIO NAME OF ATHLETE ESTEPHANIE R. ENANO


110517120031 LRN 110517100009
12/14/2006 DATE OF BIRTH 8/2/2005
AURORA NHS- MALVAR EXT. SCHOOL AURORA NHS- MALVAR EXT.
NOTE:
PLEASE USE A4 SIZE COPY PAPER

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)


Revised as of September 26, 2019 MIMAROPA
REGION
ORIENTAL MINDORO
DIVISION

SOFTBALL
EVENT

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. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED
ANGELA MAE E. ENANO KRISTINE MAE C. GERON
Grade 9 Grade 9

ANGELA MAE R. ENANO NAME OF ATHLETE KRISTINE MAE C. GERON


110517130039 LRN 110518120008
05/26/2008 DATE OF BIRTH 09/29/2007
AURORA NHS- MALVAR EXT. SCHOOL AURORA NHS- MALVAR EXT.

A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
athlete F. MEDICAL CERTIFICATE
athlete
G. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED
ANA SOPHIA Q. PEDIEGO JAYRALDINE L. CARPIO
Grade 9 Grade 8

ANA SOPHIA Q. PEDIEGO NAME OF ATHLETE JAYRALDINE L. CARPIO


110518120009 LRN 110517140007
9/7/2007 DATE OF BIRTH 5/5/2009
AURORA NHS- MALVAR EXT. SCHOOL AURORA NHS- MALVAR EXT.

A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
athlete F. MEDICAL CERTIFICATE
athlete
athlete athlete
G. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED
JEHNA DEYCHEL D. FERNANDEZ IRENE JAINNE M. DE VILLA
Grade 8 Grade 10
JEHNA DEYCHEL D. FERNANDEZ NAME OF ATHLETE IRENE JAINNE M. DE VILLA
110508140008 LRN 110508120008
3/22/2009 DATE OF BIRTH 5/16/2007
AURORA NHS SCHOOL AURORA NHS

A. AR (ATHLETE'S RECORD)
B. ORIGINAL COPY OF PSA/NSO
C. SF 10 / FORM - 137
D. CERTIFICATE OF ATTENDANCE
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
athlete F. MEDICAL CERTIFICATE
athlete
G. DISABILITY ASSESSMENT (for PARAGAMES Only)
INTERVIEWED
FRANCINE MAOMI FELIZMONTE LEAH B. SANTIAGO
Grade 10 Grade 10

FRANCINE MAOMI FELIZMONTE NAME OF ATHLETE LEAH B. SANTIAGO


110505130087 LRN 110508110011
8/4/2007 DATE OF BIRTH 9/13/2006
AURORA NHS SCHOOL AURORA NHS
NOTE:
PLEASE USE A4 SIZE COPY PAPER

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)


.
REGION

DIVISION

EVENT

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. 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
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
athlete F. MEDICAL CERTIFICATE
athlete
G. 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
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
athlete F. MEDICAL CERTIFICATE
athlete
athlete athlete
G. 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
E. PARENTAL CONSENT/AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE & CUSTODY
athlete F. MEDICAL CERTIFICATE
athlete
G. 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)

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