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    2024_-Athlete-Record

    Uploaded by

    Hershey Yssabella Ruffamari Perez

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd

    2024_-Athlete-Record

    Uploaded by

    Hershey Yssabella Ruffamari Perez
    1 views2 pages

    Copyright

    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
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    Download as xlsx, pdf, or txt
    1 views2 pages

    2024_-Athlete-Record

    Uploaded by

    Hershey Yssabella Ruffamari Perez

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Download as xlsx, pdf, or txt
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    Revised as of February 2024

    AR (ATHLETE RECORD)
    Republic of the Philippines
    Department of Education
    REGION VIII (EASTERN VISAYAS)
    (Region)
    LEYTE DIVISION Latest 1.8 inches x 1.4
    (Division) inches picture

    (School)

    (School Address)

    A. PERSONAL DATA:

    Name:
    (Last) (First) (M.I.)

    Sex: Learner Reference Number (LRN) Contact Number


    Date of Birth:
    (mm/dd/yyyy) Age: Place of Birth:
    School: Grade Level
    Address of School:
    Present Address:
    Parents:
    Fathers Name Mother/Guardian
    Address of Parents/Guardian:

    B. Participation in the previous Palarong Pambansa. Yes ____ No _____ . If Yes, kindly fill up the table below
    Year of Participation Sports Event Venue Remarks

    C. Athlete's Participation in the Lower Meets (For the Current School Year)
    Inclusive Dates Sports Event Athletic Meet Remarks

    (Use separate sheet if necessary)

    Athlete's Signature over Printed Name

    D. Certification on Athlete's Participation


    This is to certify that based on our knowledge, the above-mentioned athlete has been a member of a school based club and has
    participated in the lower meets.

    Name and Signature of Division Name and Signature of


    Meet Name and Signature of Coach
    Sports Officer (DSO) Regional Sports Officer (RSO)

    Screened by:

    Division Meet Regional Meet Palarong Pambansa

    (Signature of DSAC over Printed Name) (Signature of RSAC over Printed Name) (Signature of NSAC over Printed Name)

    Date: ______________ Date: ______________ Date: ______________

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

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