AR-I (ATHLETE RECORD)

A. PERSONAL DATA:
Name: Sex:
(M.I.)
Date of Birth: (mm/dd/yy) Age: Place of Birth:
School: Learner Reference Number (LRN)
Address of School: Student Number
Home Address:
Parents:
Address of Parents:
B. Athlete's Participation in Local/International Competition
Remarks
District/Unit Meet
Division/Provincial Meet
Regional Meet
Palarong Pambansa
Others
(Use separate sheet if necessary)
C. Athlete's Participation
This is to certify that based on our knowledge the above-mentioned athlete has participated
in the lower meets.
Name of Coach
District/Unit Meet
Division/Provincial Meet
Regional Meet
Palarong Pambansa
Others
(Use separate sheet if necessary)
Screened by:
Division Meet Regional Meet
Region
Division
(Last)
Mother/Guardian Fathers Name
(First)
Inclusive Dates Sports Event Athletic Meet
Signature Division PESS Supervisor/s
Athlete's Signature
Athletic meet
Latest 1 x 1 picture
Date: Date:
(Signature over Printed Name) (Signature over Printed Name)