Republic of the Philippines Department of Education Region IV - A CALABARZON SCHOOLS DIVISION OF LIPA CITY Brgy. Uno, Lipa City “Tat No: (04) 7561910 Telelon (08) 5629 mal Addre: Seeipait-iaioocom October 1, 2015 DIVISION MEMORANDUM No. 60 7 8.2015, 2015 DIVISION ATHLETIC MEET To: Asst. Schools Division Superintendent Curriculum Implementation Division School Governance and Operations Division Public and Private Elementary and Secondary School Heads OSDS Personnel All Others Concerned 1, With the theme: “Kabataang Lipefto, Sa Isports Ibandera Galing at Talento”, DepEd Lipa City will conduct the 2015 Division Athletic Meet for regular, students with disability and Alternative Learning System (ALS) athletes to be held in different contest venues on November 10-14, 2015. 2. This endeavor aims to: 2.1. provide concept techniques, exciting sports activities that will enhance the health related physical fitness of athletes; 2.2. widen the base for division Sports Talent identification, selection, recruitment, training, and exposure of athletes; 2.3. instill values inherent in sports among studentry; 24. improve the self-esteem and confidence of children with disability and students under the ALS program through sports activities; 2.5. come up with pool of athletes to compose the division selection for Regional Meet; and, 2.6. intensify trainings to enhance the athletes sports prowess in order to improve the performance in the Regional Meet both in elementary and secondary levels. 3. The Division Athletic Meet Executive Committee shall be chaired by the OIC- Schools Division Superintendent. The lists of the members of the Executive Committee and the ‘Technical Management Working Committees are provided in the Enclosure 1.4, The sports events played in the 2014 Division Athletic Meet shall remain in effect. Futsal shall be played; however, shall only be a demonstration sports. 5. Accordingly, only the athletes who have joined the lower level of competitions can participate in the Meet. Participation rules to be implemented are anchored on DepEd Memorandum No. 95, s. 2015. 6. The deadline for submission of athletes’ documents, and so with the official list of entries are due in the division office on or before November 5, 2015. The Division Meet Secretariat shall receive and keep the pertinent documents of the athletes upon submission of the Division Screening Committee. 7. Winning athletes and coaches who will be selected by the Division Selection Committee are duly expected to participate in the higher level of competition. Failure to do shall be meted out with the corresponding sanction upon recommendation of the committee which shall be formed to serve the purpose. It is advanced to all concerned that pursuant to Administrative Order No. 103, s. 2004 (Adoption of Austerity Measures in the Government), only winnable teams shall be sent as official entry to the 2015 Regional Athletic Meet. 8 The Olympic Medal System shall be applied for this year’s Division Athletic Meet to determine the general championship. Hence, ranking shall be based first on the total number of gold, silver, and bronze medals to be contested by the Sports Events as provided in Enclosure No. 5. 9. Education Program Supervisors for SGOD, SPED and MAPEH, ALS Specialists, Medical Officer III, Chairman of Division Screening Committee, President of the Lipa Private School Sports Association, Tournament Managers, Event Coordinators, Over-all Chairman of the event, committee on physical arrangement and grounds, and SPED coordinator will have a Consultative Meeting to be held at DepEd Conference Room on October 23, 2015 at 3:00 pm. 10. A solidarity meeting of all tournament managers, meet officiating officials, coaches from both public and private schools will be held at Padre Valerio Malabanan Memorial School Gym on November 9, 2015 at 8:00 am. Sports clinic will follow after the solidarity meeting. 11. All personnel concerned must attend the Opening and Closing Programs. 12, The opening program at the De La Salle - Lipa shall commence after the parade. The parade will start at Lipa City Youth and Cultural Center and will be participated by the Division Sports Council, athletes, coaches, and officiating officials. 13. All members of the Technical Management Committees shall observe the No Alcohol, No Smoking and No Gambling policies of this Department during the Meet. All chairpersons of the various committees and tournament managers are instructed to ensure compliance of their respective members. Violators shall be dealt with accordingly. 14. School heads are expected to provide all athletes with learning interventions as part of their academic program to compensate for missed lessons. Likewise, they shall also takeresponsibility in assigning competent teacher(s) to handle affected classes in compliance with 180 days non-negotiable teacher-pupils/ students contact time. 15. Consistent with the DepEd’s existing policies and guidelines in resolving protest on game technicalities of any sports event, and protest on eligibility, complaints should be in written form, duly signed by the coach and noted by the Head of the Delegation. A complaint shall be accompanied by affidavits of witnesses and/or evidence to support the same and shall be filed before the start of the second game of the concerned team. 16. The following documents are enclosed for reference: Enclosure 1 Deped Schools Division of Lipa City Sports Council and Technical Working Committee Enclosure 2 List of Officiating Officials Enclosure 3 Composition and Numbers of Athletes/Officials/Chaperons per sports Enclosure 4 Rules on Participation and Requirements Enclosure 5 Number of Medals to be Contested by Sports Events 17. Expenses relative to the conduct of this activity shall be charged against Special Education Fund (SEF) subject to usual accounting and auditing rules and regulations. 18. __ Immediate dissemination of this Memorandum to all concerned is eamestly desired. OIC - Schools Encls: As Stated References: DepEd Memorandum No. 95, s. 2015; Regional Memorandum dated Sept. 9, 2015, To be indicated in the Perpetual Index under the following subjects: SPORTS (OFFICIALS TRAINING PUPILS PROGRAM ANDEVENTS — STUDENTS SPECIAL EDUCATION FUND ENP / AID eosEnclosure 1 to Division Memorandum No. 60, s. 2015 2015 ORGANIZATIONAL STRUCTURE DIVISION 2015 DIVISION ATHLETIC MEET ATHLETIC November ib, 2015 @7 MEET DEPED SCHOOLS DIVISION OF LIPA CITY SPORTS COUNCIL Honorary Officials: Hon.Meynardo A.Sabili = iy Mayor Hon. Eric B. Africa - City Vice-Mayor Alty. Leo S. Latido = City Administrator Kathleen Briones = City Councitor Mark Aries Luancing, = City Councilor Ma. Concepcion Hernandez - ify Councilor Aries Emmanuel Mendoza - City Councilor Joe! Pua = City Councilor Raul Montealto = City Councilor Pacita Leviste = City Councilor Leonilo Catipon = City Councilor Nonato Montero = City Councilor Donato Linatoc City Councitor Judy M. Macasaet = OIC Accounting Office Ricardo Libon = OIC Agriculture Office Engr. Ma.JulitaL. Andal ty Assessor Elvira L. Lingao - City Budget Officer Rolando Sarmiento Jr. = Gily Civil Registrar Ester Saludo = O1C= Community Affairs Office Ramelo Mendoza - City Cooperatives Officer Engr. Roldan Lopez = OIC-City Engineering Office Engr. Eduardo Panza = City Environ. & Nat. Res. Officer Marilyn Molino = OIC City General Services Office Dr. Corazon M. Sabile = OIC - City Health Office Ally.DominadorC.Mauhay Ill - OIC - City Legal Office Ronaldo V. De Castro ~ City Personnel Officer Lorna M. Africa - — Gily Planning and Deo't Coor. Lerma Laylo = O1C-CsWDO Doroteo P. Rosales = Gity Treasurer Dr. Samuel P. Comia = City Veterinary Officer Dr. ArmandoS. Mendoza - —_—KLL College President Overall Chairman: LudyN. Pasagui Schools Division Superintendent Overall Co-Chairman: Osias $, Monforte Assistant Schools Division Superintendent Members : Lorna R. Medrano, Ph. D. Chief, Curriculum Implementation Division Leah Marie Monica K. Lumbres Administrative Officer V Asuncion J. De Luna - EPS -SGOD Annie C. Atienza, Ed. D. - EPS-MAPEHMaria Fe C. Bautista Minerva C. Caraos Fernando B. Enriquez, Ed. D. Theresa G. Exconde Alberto M. Laroza Editha M. Malihan Felipa A. Morada, Ed. D. Marife T, Morcilla, Ph. D. Leonides D. Chumacera, Ed. D. Fe M. Lacatan Manolito T. Medrano Raymundo. Poral Ines A. Andal Julie G. Hermosura Emma L. Resaba Francia C. Silva, Ed. D. Edilberto O. Mercado, Ed. D. Lydia D. Sarmiento, Ed. D. Gerardo R. Mosca Amel R. Casanova Roland D. Diaz, Ed. D. Ariel D. Garcia Elisa L. Surwela, Ed. D. Elvie M. Malaluan Shella M. Masilang Joseph Christian C. Tapire Raymund P. Bautista Perla Vicenta M. De Castro Santos R. Pagcaliwangan Corazon I. Malaluan Grace V. Camaganacan Marina B. Dimaculangan Melba B. Endozo Jeffrey M. Santos Jun Patrick V. Balita ‘Atty. Sheyna Marie M. Extra Ellen M. Almarez, Joie R. Bautista Johanna C. Bergonio Rosalina A. Briones Remelyn B. De Galicia Glenda A. Sambayan EPS ~ Kinder/SPED EPS - English EPS - Filipino EPS ~ Mathematics EPS ~ TLE EPS ~ Araling Panlipunan EPS ~ Science EPS ~ EsP PSDS ~ North PSDS - North PSDS - East PSDS - East PSDS - West PSDS - West PSDS ~ South PSDS - South PSDS - Secondary PSDS - Secondary Specialist I~ ALS Specialist Il - ALS Sr. Specialist ~ SocMob Sr. Specialist ~ M&E Sr. Specialist - HRD Specialist I~ M&E ‘Specialist Il - SocMob Specialist It ~ HRD Proj. Deo't Officer It ‘Medical Officer IIL Dentist It Dentist IT Nurse Nurse Planning Officer 1 Engineer 111 ICT Officer I Legal Officer AO IV — Personnel AO IV - Cashier AO IV - Supply AO V - Budget Officer It Accountant IIT AO IV - Records ‘The Management Working Committees 1. Managers of the Meet. Mrs. Ludy N. Pasagui - OIC - Schools Division Superintendent Mr. Osias S. Monforte : Asst. Schools Division Superintendent Mrs. Asuncion J.DeLuna = EPS-SGOD2. Tournament Management Tournament Managers Regular Sports Aubletics 2 Danilo B. Tapay = Badminton - Lorenzo T. Asinas, Ed. D.- Baseball - Rolando L. Malaluan - Basketball Froilan Aguila : Chess - Mary Jane Preciousa V. Perez. Football = Joel Lanceta Lawn Tennis - Henry Gonzales - Sepak Takraw - Nestor L. Lasin - Swimming — - Emma Garilao Table Tennis - Marites P. Fabia - Taekwondo - Amiel Maldonado - Volleyball =~ Nelson Zara e Demonstration Sports Futsal : Emily Babasa - Tournament Secretaries Regular Sports Athletics ‘AgnesC.Morada- Badminton - Azucena A. Camaganancan- Baseball - Luz.S.Mantuano~ Basketball - Gina T. Altamirano ~ Chess - Sonia E. Plete - Football : Leonardo L. Enriquez Jr- Lawn Tennis - Francis C, Mandrique - Sepak Takraw - ChonaM. Mendoza - Swimming — - Eva M. Lasin e Table Tennis - Janice T. Fischer - Tackwondo - Geraldine R.Baculo - Volleyball - Norlita©.Moren ~ Bugtongnapulo ES Inosloban-Marawoy NHS Sen, Claro M. Recto MS Canossa Academy Lipa City Science NHS Lodlod NHS Padre Valerio Malabanan MS Bolbok ES Fernando Air Base NHS Lipa City NHS Padre Valerio Malabanan MS De LaSalle Lipa Edilberto L. Mendoza MES Brion Silva MS Malagonlong ES Inosloban-Marawoy NHS Inosloban-Marawoy NHS Bulacnin ES Inosloban-Marawoy NHS Labac ES San Sebastian ES Fernando Air Base NHS Inosloban-Marawoy NHS San Isidro ES »**Toumament Secretary - checks the daity attendance f the Sports Officials; gathers game results to be submitted to the validators and recorders every end of the game; claims the AM/PM snacks and lunch of the officials; and prepares the Final Game Results duly signed by the Tournament Managers and Coaches. 3. Jury of Appeals Chairman Alty. Sheyna Marie M. Extra Members: Marife T. Morcialla, Ph. D. Edilberto O. Mercado, Ed. D. Leonides D. Chumacera, Ed. D. Emily Babasa Grace Gardiola Basilio Balayong, Ed. D. 4, Procurement Committee Chairman: Ally. Leo. Latido Members Doroteo P. Rosales Marilyn Molino Judy M. Macasaet, Elvira L. Lingao Legal Officer EPS - ESP PSDS - Secondary PSDS - North DLSL Canossa Academy President, APPEAL City Administrator City Treasurer OIC-City Gen, Services Office OIC - Accounting Office City Budget Officer5. Finance Committee Chairman Members Joie R. Bautista - Editha M. Malihan = Rosalina A. Briones 5 6. Supplies and Equipment Committee Chairman Members 7. Games Results, Communication, and Documentation Committee Chairman Co-Chairman Members Documentation + Validators Records Officers : Johanna C. Bergonio - Randy F. Falculan 2 Renato F. Fajutagana E Manuel L. Perile - Osmundo C. Cator Jr. : Beato V. Florentino Jr. a Jocelyn Amado - Martin Dimaano - Minerva C. Caraos - Fernando B. Enriquez, Ed.D. ~ Celeste B. Agonia - John Lerry Villalobos - ‘Ariel Abel _ Jeric Dorado : Liezel M. Villanueva > Mercedes Jumarang, z Leo C. Atienza - Adelia M. Orsos - EvaT. Leyesa = Florentina L, Relos - Merced M. Olave : Angelica F. Olaso - Wendy Babao : Liza O. Calibara 2 Teresita A. Calingasan a 8, ParaGames Coordinating Committee Chairman, Co-Chairman Members Maria Fe C. Bautista i Lourdes E. de Jesus 3 Edna Katigbak - Adelfa Benturansa S Ervin Salupare = 9. Division Screening, and Accreditation Committee Chairman Co-Chairman, Members ‘Atty. Sheyna Marie M. Extra - Roldan A. Lumbera a Perla Vicenta M. De Castro, MD- Santos R. Pagcaliwangan, DMD - Lourdes E. de Jesus - ‘Arnel C. Casanova % Josefa Pamela M. Flores - Merlita R. Castro - Roberto B. Rodriguez - Henedina I. Silva - AOIV- Cashier EPS - Araling Panlipunan AOV - Budget Officer AOI - Supply Anilao NHS Pag-olingin Bata ES ‘Tangob ES: Pinagtongulan ES Cumba-Quezon ES Administrative Aide VI ‘Administrative Aide VI EPS - English EPS — Filipino Lipa City NHS Lipa City NHS Bolbok NHS Bugtongnapulo NHS Inosloban-Marawoy NHS Lipa City NHS San Celestino NHS Padre Valerio Malabanan MS Brion Silva ES Sen. Maria Kalaw Katighak MS San Guillermo ES Bugtongnapulo NHS Duhatan ES ‘Tambo ES San Celestino ES EPS - Kinder/SPED Sen. Claro M. Recto MS Sen. Claro M. Recto MS G.B. Lontok MS Sen. Claro M. Recto MS Legal Officer Sto. Nino ES Medical Officer III Dentist I ‘Sen. Claro M. Recto MS Educ. Program Specialist ~ ALS ‘San Lucas ES Plaridel ES Pinagkawitan ES Don Leon Dolor MESAurora S. Lina Marilyn V. Lubis Purificacion C. Hernandez Arlin C. Bravo Evangeline B, Escabel Joe I. Titular 10, Program and Invitation Committee Chairman ‘Members 11. Selection of Athletes Chairman Co-Chairman Members 12, Medical/Dental Staff Chairman Co-Chairman Members Elisa L. Surwela, Ed. D. Roland D. Diaz, Ed. D. Shella M. Masilang Elvie M. Malaluan Joseph Christian C. Tapire Raymund P. Bautista Mark Jolan Coronel Roldan T. Resma ‘Tournament Manager of the Event Winning Coach of the Event ‘Coaches of the Event Perla Vicenta V. De Castro, MD - Santos R. Pagcaliwangan, DMD - Corazon M. Malaluan, DMD Grace Camaganacan, RN Marina B. Dimaculangan, RN Rosario T. Araja 13, Physical Arrangement/Grounds Chairman (Co-Chairman Members 14, Awards Committee Chairman Co-Chairman Members Jeffrey M. Santos ‘Angelo M. Mendoza Amel R. Vivas, Ramon R. Mercado Ciriaco V. Tapire Luis G. Silva Jr. Santiago S. Moren Renato C. Caraig Ariel D. Garcia Ederlinda B. Tiquio Edita T. Olan Maria Valenzuela Anafe S. Kaibigan Cresenciana B. Valencia Ligaya T. Castillo Flordeliza S. Punzalan Roselyn C. Llanes Sico ES Rafael M. Lojo MS Bolbok ES Rizal ES Fernando Air Base NHS San Isidro NHS SEPS - HRD ‘SEPS - SocMob EPS Il -SocMob EPS Il-M&E EPS Il- HRD PDO San Celestino NHS Inosloban-Marawoy NHS Medical Officer I Dentist II Dentist 11 Nurse II Nurse Il Dental Aide Engineer Ill San Isidro ES Lodiod NHS Calamias ES Sto. Toribio ES G.B. Lontok MS San Isidro ES Tangway ES SEPS -M&E Pangao ES TM Kalaw MS Anangi ES, Dagatan ES San Francisco ES Tipakan ES Sampaguita ES Kayumanggi ES15, Food Committee Chairman Co-Chairman ‘Members 16, Parade Committee Chairman Co-Chairman Members Jaynieve M. Caguimbal Liza Ghay F. Fronda Shirley T. Soquiat Flordeliza L. Ritan Merlinda M. Silva loli T. Briones Jean B. Escolano Loria R. Carandang, Nelly C. Atienza Babylyn M. Mauhay Elena A. Tabora FeO. Del Rio Manolito T. Medrano Armando M. Adaya Franklin C. Monteclaro Leo C. Javitia Mercedita Mendoza Gerardo R. Mosca Arnel C. Casanova Administrative Assistant I Administrative Aide VI Talisay ES Sto. Toribio ES (North) San Adriano ES Malitlit ES Tibig FS Fernando Air Base ES Pagolingin ES Labac ES Rizal NHS San Celestino NHS PSDS - East Lipa City NHS G.B. Lontok MS Bulacnin NHS, Lipa City NHS EPS II- ALS, EPS Il- ALSEnclosure No. 2 to Division Memorandum No. 60s. 2015 NAME Danilo B. Tapay Virgilio G. Gonzales Lito M. Saludo Cesar C. Maray Nelisa L. Pej Rodel C. Aguilera Jasmin Escalante Alex Dela Vega Noe B. Llanes: Jhun Umali |. Pablito M. Valencia Noel C. Marasigan '. Maritess J. Moster |. Alberto B. Levida . Michael Famatigan Anatalio G. Palmones . Patroneil G. Fadriquela Joedrick A. Falceso William I. Titular Edwin D. Malveda Aileen L. Guce . Maria Antonieta B, Panaligan Rica R. Cordero Mark Jolan Coronel Nolasco L. Bautista Marina M. Moreto . Ulysses D. Selim - Laila C. Lit Jesus Estellanes . Agnes C, Morada NAME Lorenzo T. Asinas Vernon B. Briones ‘Venerando M. Malate Danny F. Fajutagana ‘Amel L. Sabido Jonathan R. Carandang LIST OF OFFICIATING OFFICIALS ATHLETICS DESIGNATION Tournament Manager Starter Starter Assistant Recaller Call Room Manager Steward Judge at Finish/Timer Judge at Finish/Timer Judge at Finish/Timer Judge at Finish/Timer Chief Judge Lane Umpire Lane Umpire Lane Judge Lane Judge Lane Judge Lane Judge Lane Judge Lane Judge Lane Judge Lane Judge Lane Judge Lane Judge Lane Judge Chief-Field Event Member Member Member Member Tournament Secretary BADMINTON DESIGNATION ‘Tournament Manager Referee Referee Referee Referee Referee 2015 | DIVISION ATHLETIC 3S 7 MEET SCHOOL Bugtongnapulo ES Sen. Claro M. Recto MS Sto. Toribio ES (North) Sto. Toribio ES East) Talisay ES Don Leon Dolor MS Kayumanggi ES Inosloban-Marawoy NHS Bugtongnapulo ES Sen. Claro M. Recto MS Don Leon Dolor MS Fernando Air Base NHS San Lucas ES Dagatan ES Jose K. Obando MS ‘Tangob ES Pagolingin ES Cipriano M. Andal MES Rafael M. Lojo MS ‘Teodoro M. Kalaw MS San Celestino NHS Tambo ES Pinagkawitan NHS Pinagtongulan NHS Inosloban-Marawoy ES Edilbero L. Mendoza MES SCHOOL, Inosloban-Marawoy NHS Pinagkawitan NHS Inosloban-Marawoy NHS Lodlod NHS Bulacnin NHS Bulacnin NHS9. 10. nL, 12. B. 14. 15, 16. 17. 18, 19, 21. 2. 2. 24, SNP eR eN Pedro R. Bobadilla Eleanor M. Dimayuga Jennelyn E. Daluz. Melanie R. Corachea Renalyn C. Magcawas Rocel R. Rocafort Gerry M. Laroza William L. Andal Gerry T. de Luna Philip M. Quizon Benjo B. Desuangco Fe M. Silva Daisy L. Lopez |. Belen T. Comeso Loida O. Recede Amy T. Rocafort Rebelyn M. Calingasan ‘Azucena A. Camaganacan NAME, Rolando L. Malaluan Librado M. Paran Aaron Paul G. Morada Reymond M. Para Jose R. Mosca Porfirio R. Magnaye Boyd L. Aguila Federico P. Masilang, Allan Latayan |. Joseph Camacho . Jesper F. Fabregas Noel F. Fababaer . Agnes O. Titular . Emely J. Silva . Brigildo M. Equia 5. Lichel A. Lumbera Luz $, Mantuano NAME Froflan Aguila Blas J. Villapando Edilberto Tarrayo Joseph U. Casumbal Denis M. Mojado Allan A. Balotcopo Lamberto M. Katigbak Jr. Glenn M. Lacerna Referee Court Official Court Official Court Official Court Official Court Official Court Official Court Official Court Official Court Official Court Official Court Official Court Official Court Official Court Official Court Official Court Official ‘Tournament Secretary BASEBALL DESIGNATION Tournament Manager Chief Umpire Assistant Chief Umpire Umpire Umpire Umpire Umpire Umpire Umpire Umpire Umpire Chief Scorer Scorer Scorer Scorer Tournament Secretary BASKETBALL DESIGNATION Tournament Manager Asst, Tournament Manager Referee Referee Referee Referee Referee Referee San Celestino NHS Lumbang NHS Inosloban-Marawoy NHS San Isidro NHS Bulacnin NHS Duhatan ES Rafael Lojo MS Bagongpook ES G.B. Lontok MS Bulacnin ES G.B. Lontok MS ‘Tipakan ES Inosloban-Marawoy ES Rafael M.Lojo MS Inosloban-Marawoy ES Fernando Air Base NHS Pinagkawitan ES Brion Silva ES SCHOOL Sen. Claro M. Recto MS Lodlod NHS Lipa City National HS Tangway ES Sen. Claro M. Recto MS Anilao ES G.B. Lontok MS Labac ES Duhatan ES Paninsingin ES Mabini ES ‘Teodoro M. Kalaw MS Sen. Maria Kalaw Katigbak MS ‘Tangway ES Malagonlong ES SCHOOL Inosloban-Marawoy NHS Pusil ES Pangao ES San Benito ES Teodoro M. Kalaw MS ALS10. nL. 12; B. 14. pepo BeeNoueene Boe Aakene Jeffrey C. Santander Joeben L. Austria Jocelyn R. Dasilio ‘Adrian P. Ramos Mercedita R. Mendoza Gina T. Altamirano NAME Mary Jane Preciousa V. Perez Jayson M. Samson Cielito C. Lozano Lourdita V. Titular Arnel C. Lucing, Melba O. Mistas Julita O. Lumbera ‘Anicia M. Padura Remedios Silva |. Sonia E. Plete NAME Joel Lancita Jessah A. Macaraig Nevard Glenn A. Orsos Jayson M. Dizon Romano Garcia Nanette M. Tuason Michael Macasaet Hazeron F. de Mesa Emmanuel Mercado Leonardo L. Enriquez Jr. NAME Henry Gonzales Jennifer M. Narte Erie F, Fajutagana Gilbey P. de Castro ‘Mark Joseph de Castro Mary Jane Paragas Cesar Sandagon Jaime L.. Ng, Julious M. Magaling, Francis C, Mandrique ‘Table Committee Table Committee Table Committee Table Committee Table Committee Tournament Secretary CHESS DESIGNATION ‘Tournament Manager Chief Arbiter Co-Chief Arbiter Arbiter Arbiter Arbiter Arbiter Axbiter Axbiter ‘Tournament Secretary FOOTBALL DESIGNATION Tournament Manager ‘Technical Official Technical Official Technical Official Technical Official ‘Technical Official Technical Official Technical Official Technical Official Tournament Secretary ‘LAWN TENNIS. DESIGNATION ‘Tournament Manager Chief Referee/Umpire Referee/Umpire Referce/Umpire Referee/Umpire Referee/Umpire Referee/Umpire Referee/Umpire Tournament Secretary Inosloban-Marawoy NHS Lipa City NHS, Fernando Air Base NHS Bulacnin NHS Lipa City NHS Inosloban-Marawoy NHS SCHOOL Lipa City National Science San Isidro NHS Padre Valerio Malabanan MS Teodoro M. Kalaw MS Inosloban-Marawoy NHS San Isidro NHS Pinagkawitan ES Inosloban-Marawoy ES Anilao ES. Inosloban-Marawoy NHS SCHOOL, Padre Valerio Malabanan MS Pinagkawitan ES Pinagkawitan NHS Lodlod ES ‘Tambo ES Pinagkawitan NHS Bulacnin ES SCHOOL Lodlod NHS Pinagtongulan NHS Mabini ES Pinagtongulan NHS Bolbok NHS ‘The Nazareth School ‘Tagbakin ES Bolbok NHS Inosloban-Marawoy NHSyeNaghepe NAME Nestor L. Lasin Michael M. Maglinao Richard B. Magbatoc Lani C. Lasin Jasmin M. Cuizon Neneth G, Macasaet Ria D. Catindig, Elmie S. Silva ‘Chona M. Mendoza NAME Emma E. Garilao Vilma L. Marasigan Gloria N. Naling, Nancy H. Kundangan Avelinda T. Medrano Babylyn T. Hermogenes Salvie M. Arellano ‘Alma M. Manalo Evelyn P. Aguilera Edith F. Abdon ‘Mylene L. Falcarin Shervin L. Ng Emilio Amago Jun Katigbak Merlyn H. Las Penis Eva M. Lasin NAME Marites P. Fabia Jerry T. Budomo Sixto M. Hernandez, Ronaldo I. Dalanon Reden L. Gonzales Demetrio L. Lingao Edgardo M. Zara Janet D. Hernandez, Guadalupe G. Dimailig Chona E. Catindig Amelita E, Ocenar Brian M. Lacerna Jeffrey E. Lagaya .. Marissa Nario . Marie Joy M. Balela . Rizalina T. Diola Gina Rosita SEPAK TAKRAW JRS DESIGNATION ‘Tournament Manager Referee Referee ‘Technical Official ‘Technical Official Technical Official ‘Technical Official Technical Official Tournament Secretary SWIMMING DESIGNATION ‘Tournament Manager™ ‘Technical Official Technical Official Technical Official ‘Technical Official ‘Technical Official Technical Official ‘Technical Official ‘Technical Official ‘Technical Official ‘Technical Official ‘Technical Official ‘Technical Official ‘Technical Official Technical Official ‘Tournament Secretary TABLE TENNIS DESIGNATION ‘Tournament Secretary Chief Umpire (Sec) Chief Umpire (Elem) Umpire Umpire Umpire Umpire Umpire Umpire Umpire Umpire Umpire Umpire ‘Umpire Umpire Umpire Umpire SCHOOL Padre Valerio Malabanan MS Bulacnin NHS Lipa City NSHS Sampaguita ES Padre Valerio Malabanan MS Bagongpook ES Sen. Claro M. Recto MS San Salvador ES Labac ES SCHOOL, Bolbok ES Padre Valerio Malabanan MS Bagongpook ES Sampaguita ES Rizal ES ‘Cumba-Quezon ES Sampaguita ES ‘Tipakan ES Rizal NHS Teodoro M. Kalaw MS ‘Teodoro M. Kalaw MS Halang ES The Nazareth School De La Salle Lipa Sen. Claro M. Recto MS ‘San Sebastian ES SCHOOL Fernando Air Base NHS Fernando Air Base NHS Fernando Air Base ES Abundio Torre FS Pinagkawitan ES Sampaguita ES Sampaguita ES Bagongpook FS Rafael M. Lojo MS Bolbok ES Dagatan ES Fernando Air Base NHS Fernando Air Base NHS Lumbang NHS Lipa City NHS Fernando Air Base NHS Fernando Air Base NHS18. 19, Lucia A. Cueto Janice T. Fischer NAME Amiel M. Maldonado Mary Grace L. Gardiola Renato Dimaano John Earl Elmer Vale Anton Bernardo Rommel Manguya MJ Cator Edmundo F. Fetalvero |. Donata Rowena E. Legaspi Cristy Mandigma Isabel M. Tolentino Rosalinda K. Nishikawa . Edna Bandelaria Ma. Vivian B. Villena . Clifford Famorcan . Jerome U. Osello . Rovel Punzalan Geraldine B. Hernandez NAME Nelson L. Zara Aleli C. Nitoral Mark Jason M. De Jesus Edson P. Enrico Harriet F. Llanes Raquel Hatia Rhea D. Asi Carine V. Medrano Adrian R. Landicho ‘Melanie Ann P. Carandang, Purisima A. Mantuano . Irene M. Perez. Madeline M. Esguerra Glenda P. Lingao Ramil L. Gonzales Sharon T. Gonzales Nolits C. De Luna . Lovely Joy Latoza Melody A. Gura . Alexander Simagala Imelda Mendoza Pablo Katigbak Umpire ‘Tournament Secretary TAEKWONDO DESIGNATION ‘Tournament Manager (Elem) ‘Tournament Manager (Sec) Chief Referee (Elem) Chief Referee (Sec) Referee/Judge Referee/Judge Referee/Judge Referee/Judge Corner Judge Comer Judge Comer Judge Corner Judge Records Records Records Timer/Inspection Timer/Inspection Timer/ Inspection ‘Tournament Secretary VOLLEYBALL DESIGNATION ‘Tournament Manager Chief Referee Referee Technical Official ‘Technical Official Technical Official Technical Official Technical Official Technical Official Technical Official Technical Official ‘Technical Official Technical Official Technical Official Technical Official Technical Otficial Technical Official Technical Official ‘Technical Official Technical Official Technical Official Technical Official Piangkawitan NHS Fernando Air Base NHS SCHOOL Lipa City NHS ‘Canossa Academy De LaSalle Lipa Fernando Air Base NHS Bugtongnapulo NHS Canossa Academy Don Leon Dolor MS Jose K. Obando MES Sen. Claro M. Recto MS Fernando Air Base NHS Sto. Toribio ES (North) ‘Bagongpook ES Inosloban-Marawoy NHS SCHOOL Padre Valerio Malabanan MS Paninsingin ES Lipa City NHS Pangao ES Padre Valerio Malabanan MS San Carlos ES San Salvador ES Tambo ES San Sebastian ES Sen. Claro M. Recto MS Bolbok ES Sen. Claro M. Recto MS Pinagkawitan ES San Jose ES G.B, Lontok MS G.B. Lontok MS Jose K. Obando MES Pinagkawitan ES Tipakan ES G.B. Lontok MS De La Salle Lipa Lipa MontessorizB. 24, 2. 26. 27. 28. 29. Rocel Sumead Aladin Mayuga Mario Katigbak Ronalyn M. Enrico Richard Bon Paterno F. Fadrilan Dennis G. Jumarang 30. Ma. Concepcion R. De Castro 31 Edgardo M. de la Petia 32. Norman C. Calalo 33, }. Norlila O. Moren ‘Technical Official Technical Official Technical Official Technical Official ‘Technical Official ‘Technical Official ‘Technical Official Technical Official Technical Official Technical Official Tournament Secretary De La Salle Lipa Canossa Academy De La Salle Lipa Lipa City NHS Rizal NHS Sen. Maria Kalaw Katigbak MS Fernando Air Base NHS Rizal NHS Rizal NHS Inosloban-Marawoy NHS San Isidro ESEnclosure No. 3 to Division Memorandum No. 60 s. 2015 2015 | DIVISION COMPOSITION AND NUMBERS ATHLETIC OF ATHLETES/OFFICIALS/CHAPERONS MEET es PER SPORTS Delegation Officials for Elementary and Secondary Divisions Heads of Delegation Public School District Supervisors President - LIPRISAA Athletic Manager Sports Coordinator Football _ ‘Sepak Takraw JR Swimmin; Table Tennis “Taekwondo VolleyballB._SECONDARY LEVEL sepa Takraw SR mame C_DEMONSTRATION SPORTS, ‘EVENTS GENDER ‘NUMBER OF ATHLETES [COACH | CHAPERON | TOTAL 7 Hl i i z z 7 1! Futsal Girls TotalEnclosure No. 4 to Division Memorandum No. 60s. 2015, 2015 DIVISION ATHLETIC @~ MEE MEET RULES ON PARTICIPATION: A. Participants Participants to the Division Meet are elementary and secondary pupil/student-athletes from public and private schools who have participated in the lower meets (intramurals and area meet)/Private Schools Athletic Meet. B. Fligiblity of Athletes 1.Must be a Filipino citizen and enrolled in recognized schools at the beginning of the current school year. 2.A foreign athlete enrolled in recognized schools (schools with recognition/ permit to operate) in the Schools Division of Lipa City; however, may also participate provided only one (1) is allowed to play in team sports events (football, volleyball, basketball, softball, baseball) only. Furthermore, the foreign athlete must pass the qualification set for Filipino athletes. 3. Must have attended and passed all subjects in the curriculum grade level. 4.Should have participated in the preliminary meets (school intramurals and District Meets). 5. Transferee from one division to another within the region is allowed to participate provided they have participated in the lower meets. 6.For elementary athletes, he or she should have been born in 2003 or after; and for secondary athletes, he or she should have been born in 1998 or after. Thereafter, add one year to the cut- off date for the succeeding year. 7.As a general rule, elementary athletes shall play in the elementary division and secondary athletes shall play in the secondary division. Disqualification 1.Over-aged athletes, 2. Athletes who have represented the Philippines in the South East Asian Games (SEA Games) and Olympic Games and International Sports Federation sanctioned by regional or world championships are disqualified to play in the same event they have participated in aforementioned games. However, they Can participate in other different sports events in the Division Meet. 3. Athletes who are member of the national pool are not qualified to play. 4. Failure to submit the required documents. 5. Penalized with suspension or ban during the previous meets. D. Required Documents to Participate in the 2015 Division Athletic Meet printed in Ad size bond. paper (see Annexes) 1 Photo gallery of coach, assistant coach, chaperons, and athletes 2. Requirements of coach, assistant coach, and chaperons a. Certificate of Employment (certified true copy of the original document and duly notarized); b. Form 212/Personal Data Sheet with tree (3) ID pictures (soft copies of pictures must also be submitted); c. Medical Certificate d. For combative sports, certificate of participation with accreditation /trainings/seminar in each coach’s respective sports events sponsored or conducted by DepEd or any reputable Association and/or must have been a coach for at least two (2) years in respective sports events;Affidavit of the coach, attesting the authenticity, validity, and correctness of the entries of submitted documents by athletes. 3. Athlete's Record with Learner Reference Number (LRN) 4. Athlete's documentary requirements a. Original and photocopy of Birth Certificate issued by the National Statistics Office (NSO). Late registration may be accepted, provided that it was issued one (1) year prior to the current Division Meet (in the case of a foreign-born Filipino athlete, in lieu of NSO Birth Certificate, the original birth certificate issued by the country of his/her birth and a valid passport or a document issued by the Bureau of Immigration/Department of Foreign Affairs, showing his/her nationality as a Filipino; b, Form 137, certified true copy from original, duly prepared and signed by the Teacher- Adviser, Registrar/Principal/School Head, and the District/Cluster in charge of sports (in case the ratings in the second grading period are not indicated in the Form 137 of the athlete, the certified true copy of Form 138 shall be submitted; in cases of athletes who are enrolled under the alternative delivery mode [home study program/open high school program], a copy of the numerical/descriptive rating equivalent to the second grading, period of the regular classes should be submitted; in cases of athletes who are enrolled in schools under a trimester program shall submit certified copies of their grades for the 1 and 2! quarter grades; Form 137s submitted must have complete entries); ©. Certification of Completion duly signed by the School Registrar or the School Head. In the case of private schools whose curriculum year starts on July onwards, athletes shall be required to submit the certificate of attendance; 4d, Parent’s or guardian's consent, verified by the Principal/Registrar/Teacher-Adviser; e. Medical Certificate, signed by a physician, stating that the athlete is physically fit and within the age limit required, with a validity of three (3) months from the date of issue. The complete name of the signing physician shall clearly appear on the medical certificate, with the license number and date of examination. Additional Medical Form for combative sports is required, f. Dental Certificate with a universal entry, duly signed by a dentist over his/her clearly printed name and license number, and with the date of examination which should not be ‘more than six (6) months prior to the date of the opening of the Division Meet. Four (4) passport sixe 1 % X 1 % identical pictures with name tag (surname, first name, and. middle initial) and grade level to be used for the Athlete's Record, dental certificate, gallery, and Accreditation card (Soft copies of pictures must also be submitted to the Division Screening Representative. Protest on Fligibility 1.Complaints/ protests shall be in written form duly signed by the coach and noted by the Head of the Delegation and shall be filed before the start of the second game of the concerned team. 2.Complaints shall be accompanied by affidavits of witnesses and/or evidence to support the same. 3.Complaint/Protest filed by other persons shall be automatically dismissed without prejudice of refilling the same upon compliance of the above-mentioned requirement provided however that even the protest does not comply with the said requirement the Jury of Appeals may Motu Propio investigate and resolve the protest of there is an obvious truth on the merits of the allegation. 4. The complaint/ protest shall be acted immediately by the Jury of Appeals upon receipt thereof. Cases of misrepresentation, impersonation, and violation of similar nature may still be filed even, during and after the Division Meet. Sanctions 1. Any violation of the rules on eligibility is punishable by lifetime ban without prejudice to the filing of appropriate administrative and criminal charges against erring officials and athletes.2. When a violation of the rules of eligibility is proven in team competition, the games in which the individual has taken part shall be declared forfeited in favor of the opposing, team. The individual performance, in case of individual events, shall be nullified. G. Schedule of Medical and Dental Examination DISTRICT InoslobaneMarawoy NHS GB. Lontok MSEnclosure No. 5 to Division Memorandum No. 60, s. 2015 2015 MEDALS. € DIVISION ATHLETIC MEET MEDALS TO BE CONTE: ELEM-BOYS | ELEM-GIRIS | sECBOYS | SECGIRIS H100M Dash [200M Dash J4x100M Relay J4xa00M Relay s00M Run i }3000M Run I \ss Throw [Elementary Secondary [individual apa tafatatafatatagatata cam Se ee eee ESA ff a [ne fa Je eae meeeFOOTBALL ante Tal [a a [oa se I SES ae eas | TAWN TENNIS ae | 1 } aja a{4 aT co ae aT ‘SEPAK TAKRAW }200M individual Relay }200M Backstroke |4x100M Freestyle Relay 14X100M Medley Relay /4X50M Freestyle Relay /4xXSOM Medley Relay Tame aS eee cra aoa faecal Doabiar : Ee TAEKWONDO ELEMENTARY[Group A (Individual) [Group B (Individual) Finweight not exceeding 45kg Flyweight over 45 and not exceeding 48kg lBantamweight over 48 and not exceeding Sik Featherweight over 51 and not exceeding 55kg Lightweight over 55 and not exceeding 59kg Welterweight over 59 and not exceeding 63g. Lightmiddleweight Middleweight Lightheavyweight Heavyweight |SECONDARY - Girls Finweight not exceeding 42kg_ Flyweight over 42 and not exceeding 44kg Bantamweight over 44 and not exceeding 46kg Featherweight over 46 and not exceeding 49kg Lightweight over 49 and not exceeding 52kg Welterweight over 52 and not exceeding S5kg Middleweight Lightheavyweight Heavyweight |POOMSAE (Forms) [Group A (Individual) [Group B (Individual) [Team (Event) [Elementary Secondary Volleyball Mytical 6 SPECIAL AWARDS: Ellie][Basketball Mytical 5 {Volleyball MVP it Basketball MVP = JOver-all Champion _ fist Runner Up Jand Runner Up jub-TOTALRECON DION EVENT DepED Assistant Coach (only when applicable) Chaperon athlete athlete athicte NAME OF ATHAETE: {LRN 60H00L 1D. NUMBER DATE OF BIRTH SCHOOL athlete athlete NAME OF ATHLETE LRN SCHOOL 1D. NUMBER DATE OF BIRTH SCHOOL athiete athiete athlete NOTE: NAME OF ATHLETE URN SCHOOL 10. NUMBER. DATE OF eIRTH SCHOOLRepublic of the Philippines Department of Education ‘(Resion) inision CERTIFICATE OF EMPLOYMENT (for Public Schools/DepED Personnel) Date To Whom It May Concern: ‘This is to certify that Mr./Ms. is presently employed in as , since or for a period of This certification is issued upon the request of to act as coach/assistant coach/chaperon in Palarong Pambansa 20_ at School Head/Administrative OfficerRepublic of the Philippines Department of Education Reson ‘Dinisiony CERTIFICATE OF EMPLOYMENT (for Private School) Date To Whom It May Concern: This is to certify that Mr./Ms. is presently employed in as , since or for a period of This certification is issued upon the request of to act as coach/assistant coach/chaperon in Palarong Pambansa 20_ atRepublic of the Philippines Department of Education ezion Divisions io) ‘School Aires MEDICAL CERTIFICATE Dats) ‘To Whom It May Concern: This is to certify that I have personally examined age sex___born on and have found that helshe is physically fit, during the time of examination, to join and compete in the lower meets and Palarong Pambansa Event: Physical Examination Date examined: Height Weight: Blood Pressure Pulse, Resting Respiratory Rate Other Remarks: Physician/Medical Officer (Signature over printed name) License No. PTR: Date:Republic of the Philippines) City of. ) AFFIDAVIT I of legal age, address at after having duly swom in accordance with law hereby depose and state: with postal ‘That I am presently employed in as 4 ‘That | am presently employed in sinoe or for a period of 5 ‘That I was designated as coach of the fs who will participate in the 20__ Palarong Pambansa That all the athletes records submitted are true and correct to the best of my personal knowledge; ‘That all the athletes are not members of the National Team, National Training Pool and Development Pool receiving monthly stipend/allowance from the Philippine Sports Commission (PSC); That all the athletes of 1 - Who will participate in the 20__ Palarong Pambansa are eligible to play That I execute this Affidavit to attest to the authenticity and veracity of all the documents submitted Affiant SUBSCRIBED and swom to before me in » this day of month 20, affiant executing his/her Community Tax Certificate No. issued at on Notary Public Dos. No. Page No. Book No. Series ofAR-I (ATHLETE RECORD) Region Latest 1% x 1% | pee ' | | | ee lea A, PERSONAL DATA: Name sex Lear Reletence Number (LAN) Conic Hae Date Bit an Tee Schoo 2S (Prhte Sahoo Woo Adress of Soe: Home Adress Parents Fae tare eteiaan Address of Parents B. Athlote's Participation in Local/international Competition ‘Athietic Meat Remarks (Use separate sheet il necessary) Tice Senate C. Athlete's Participation ‘This is to certify that based on our knowledge the above-mentioned athlete has participated in the lower meets. [Dns Provinol Mest [Regions Meet [Pairang Pambanse (Usa coparate aaah Fressesany) ‘Screened by: Division Meet Regional Meet (Signature over Printed Name) ‘Signature over Printed Name) Date: Date:Republic of the Philippines Department of Education ‘Regiony ‘Division School) (School Adress) CERTIFICATE OF COMPLETION ate: To Whom It May Concern: This is to certify that has completed the Grade/Year (Elementary/Secondary Level) for the School Year ‘School Head/Registrar (Signature Over Printed Nome)Republic ofthe Philippines Department of Education Division) (Sehoo!) (School Address) Date ARENTAL CONSENT We hereby willingly and voluntarily give consent the participation of my/our son/daughter in the Division, Regional Meet and Palarong Pambansa T have considered the benefits that my son or daughter will derive from his/her participation in this activity provided that due care and precaution will be observed to ensure the comfort and safety of my son/daughter and that DepED employees and personnel may not be held responsible for any untoward incident that may happen beyond their control. ‘Signature of Father "Signature of Mother ‘Name of Father Name of Mother ‘Signature of Guardian over Printed name (Relationship with the Athlete) Verified by TTeacher-Adviser/School Head Registrar Remarks:Repubbic of the Phitipines 80 ey DEPARTMENT OF EDUCATION ’ ao Sh cs g y ear 3 Driond saa (School) (Sohoat deren ia ‘MEDICAL CERTIFICATE: REMARKS: CASED ON VISUAL, PHYSICAL ASSESSMENT & INTERVIEW) (rorany DATE OF EXAMINATION: ABNORMALIES) es tathletenac.e concusionin | 1sediea! Examination folowing post the post yeor piviod ater Concunion war normal, | Nome! | Abnamal Plecxe note ony: Tit 6 corals FoF Cowes | conerormectcat eam speutesyseen evans alow: | | Mento stout/Prycnologicat | at survey r Caria reve ever pus se GFT {a} Heoa eroutin. Fn. vilon by cre | | (recor Normal | Abnormat ToT Wash Moa nese Wemal__| Abnomal int Tempercmondibuer sint Warmer __| Abnorm 1B) Nee Carscalepine, Iymph neces Wermar | Abromat eee Breath suns, { ‘endemess on compesion Norma! | Abnoma! f Puke] Boos presi t | record Neral | Abronmat {d) Corcio Vascular System | Hisart exerinotion sounds, murmurs heaves. sao myth Normal | Absormat Tose ribs shouider west, hand: {e} Onnopecte system —_| fingers Nommat | Absomo! Tewari: (ankle, nee, ip) Kemal | Absomet aioe Wemal_| Abromer (Nevologicatsystem | Verbolremenies Remal_| Abaarnae Motor responses and balance Komal | Abremat Ta Astin ecord) ver Ne Typ a rSGeTOn (eco) ‘and coso0e FeEoU) Ye Go Name of Athi: D1 Frreray []notrtterioy Name of MD:_ PRC License Number: PIRNo,