OFFICIAL ENTRY FORM

GOV. BEN P. EVARDONE CUP – SEASON 5

(The Inter-Municipality/City Basketball & Volleyball
Tournament for the Province of Eastern Samar)

Instructions:
Please fill up the necessary information in the blanks below.
Please write legibly. There should be no erasures.
You may type the necessary information on the blanks below.

City/Municipality
Event (Insert whether Basketball Boys,
Volleyball Boys & Volleyball Girls.)
Complete Names of Player Jersey
Age Position
(Family Name, First Name, MI) Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
*Team Captain

Name of Team Manager

Name of Team Head Coach
Name of Team Asst. Coach
Name of Team Statistician
Name of Team Utility
Name of Side Court Reporter

I attest to the veracity of the information above and the authenticity of the documents
submitted.

Signature Team Manager

Date of Signature

SUBCRIBED AND SWORN TO before me this ______ day of ______________ 2024 in

____________________________, affiant exhibiting to me his/her ___________________ ____________.

Doc. No. _____;

Page No. _____; NOTARY PUBLIC
Book No. _____;
Series of 2024.