Revised as of September 26, 2019
AR (ATHLETE RECORD)
VI
Region
Division
A. PERSONAL DATA:
Name: Esparas Dustine Drew S.
(Last) (First) (M.I.)
Sex: Female Learner Reference Number (LRN) 441015150054 Contact Number 0933 477 1264
Date of Birth: (mm/dd/yyyy) July 29, 2010 Age: 12 Place of Birth: Bacolod City
School: Eliakim Learning Center Grade Level VI
Address of School: Hernaez St., Barangay 38, Bacolod City
Present Address: Blk. 6 Lot 20 Anchorville Subdivision, Barangay Pta. Taytay, Bacolod City
Parents: Lot Lorenz Esparas Marnie Joy Esparas
Fathers Name Mother/Guardian
Address of Parents/Guardian: Blk. 6 Lot 20 Anchorville Subdivision, Barangay Pta. Taytay, Bacolod City
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
October 6, 2022 Chess Elementary Girls Eliakim Learning Center Sports Fest Gold Medalist
January 21, 2023 Chess Elementary Girls ANOPSSAI Sub-Area Meet Gold Medalist
February 4 - 5, 2023 Chess Elementary Girls 42nd NOPSSCEA Chess Tournament Bronze Medalist
March 6, 2023 Chess Elementary Girls ANOPSSAI Area Meet 2023 Gold Medalist
(Use separate sheet if necessary)
DUSTINE DREW S. ESPARAS
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 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)
Eliakim Learning Center Sports Fest ROSSELLE MAY P. JUMAYAO
ANOPSSAI Sub-Area Meet ROSSELLE MAY P. JUMAYAO
42nd NOPSSCEA Chess Tournament ROSSELLE MAY P. JUMAYAO
ANOPSSAI Area Meet 2023 ROSSELLE MAY P. JUMAYAO
(Use separate sheet if necessary)
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)
Revised as of September 26, 2019
AR (ATHLETE RECORD)
VI
Region
Division
A. PERSONAL DATA:
Name: Fermano Yalei Shane N.
(Last) (First) (M.I.)
Sex: Female Learner Reference Number (LRN) 441053150030 Contact Number 0910 738 7476
Date of Birth: (mm/dd/yyyy) July 4, 2010 Age: 12 Place of Birth: Bacolod City
School: Eliakim Learning Center Grade Level VI
Address of School: Hernaez St., Barangay 38, Bacolod City
Present Address: Brgy. 7, Bacolod City
Parents: Norman Fermano Maricel Fermano
Fathers Name Mother/Guardian
Address of Parents/Guardian: Brgy. 7, Bacolod City
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
October 6, 2022 Chess Elementary Girls Eliakim Learning Center Sports Fest Silver Medalist
January 21, 2023 Chess Elementary Girls ANOPSSAI Sub-Area Meet Gold Medalist
February 4 - 5, 2023 Chess Elementary Girls 42nd NOPSSCEA Chess Tournament 5th Placer
March 6, 2023 Chess Elementary Girls ANOPSSAI Area Meet 2023 Gold Medalist
(Use separate sheet if necessary)
YALEI SHANE N. FERMANO
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 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)
Eliakim Learning Center Sports Fest ROSSELLE MAY P. JUMAYAO
ANOPSSAI Sub-Area Meet ROSSELLE MAY P. JUMAYAO
42nd NOPSSCEA Chess Tournament ROSSELLE MAY P. JUMAYAO
ANOPSSAI Area Meet 2023 ROSSELLE MAY P. JUMAYAO
(Use separate sheet if necessary)
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)
Revised as of September 26, 2019
AR (ATHLETE RECORD)
VI
Region
Division
A. PERSONAL DATA:
Name: Manalo Robert William
(Last) (First) (M.I.)
Sex: Male Learner Reference Number (LRN) 441015150025 Contact Number 0928 997 5153
Date of Birth: (mm/dd/yyyy) August 11, 2011 Age: 11 Place of Birth: Bacolod City
School: Eliakim Learning Center Grade Level VI
Address of School: Hernaez St., Barangay 38, Bacolod City
Present Address: Deca Homes, Barangay Cabug, Bacolod City
Parents: N/A Jane Lyka Manalo
Fathers Name Mother/Guardian
Address of Parents/Guardian: Deca Homes, Barangay Cabug, Bacolod City
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
October 6, 2022 Taekwondo Elementary Boys Eliakim Learning Center Sports Fest Gold Medalist
January 13, 2023 Taekwondo Elementary Boys ANOPSSAI Sub-Area Meet Gold Medalist
March 6-7, 2023 Taekwondo Elementary Boys ANOPSSAI Area Meet 2023 Gold Medalist
(Use separate sheet if necessary)
ROBERT WILLIAM MANALO
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 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)
Eliakim Learning Center Sports Fest ROSENIE R. ERPE
ANOPSSAI Sub-Area Meet ROSSELLE MAY P. JUMAYAO
ANOPSSAI Area Meet 2023 ROSSELLE MAY P. JUMAYAO
(Use separate sheet if necessary)
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)
