Republic of the Philippines
Department of Education
Region XI
Division of Davao del Sur
Northern Paligue, Padada, Davao del Sur
SANTA CRUZ CENTRAL ELEMENTARY SCHOOL
FORM SSC.1: SCHOOL SPORTS CLUB REGISTRATION FORM
INSTRUCTIONS: Input the necessary details. Indicate N/A if not applicable. DO NOT ABBREVIATE.
A. Basic Information
Region: XI – Davao Region Division: Davao del Sur
Name of School: Santa Cruz Central Elementary School ID: 129099
Address Poblacion, Zone III, Santa Cruz, Davao del Sur
Email address (if any) Sta.129099@[Link] Telephone No.
Website URL (if any)
B. School Profile
C. Sports Club
C.1 Mandatory Sports
At least three out of six mandatory; however, you may establish any preferred sports club. Add rows if
necessary.
1.
2.
3.
4.
5.
6.
C.2 Preferred Sports
Add rows if necessary.
1. N/A
2.
3.
4.
5.
6.
Declaration:
I hereby declare the information provided in this application is true and correct and there have been no
misleading statements, omission of any facts nor any misinterpretation made.
Prepared by:
Sports Club TERESITA Y. BAGAL
Coordinator
Signature
Date October 9, 2024
Certified by:
Principal/ Office – in - LEONILA D. BERDIN
charge
Signature
Date October 09, 2024
Verified by:
Division Sports Officer JOVETH G. TUBIANO
Signature
Date
Noted by:
Schools Governance and MARIO C. MONDEJAR
Operations Divisions
Signature
Date
Approved by:
Schools Division LORENZO E. MENDOZA, CESO V
Superintendent
Signature
Date
Department of Education
Region XI
Division of Davao del Sur
Northern Paligue, Padada, Davao del Sur
SANTA CRUZ CENTRAL ELEMENTARY SCHOOL
FORM SSC.2: School Sports Club Attachment Form
INSTRUCTIONS: Input the necessary details. Indicate N/A if not applicable. DO NOT ABBREVIATE.
I. SPORTS CLUB INFORMATION
Create a copy of this page if four or more sports clubs are being offered. Add rows and columns if necessary.
Sport’s Club Name: SCCES_SEPAK 2ND GEN
Established Date: October 28, 2023
Sports Club Facilitator/s: JESSYL D. CRUZ
Sports Club Member/s:
Members’ Name Grade Level
MEGGIE JAMES T. BOTANAS GRADE 6
JOSH YOHANN N. ELLAGA GRADE 5
JESS FRANCIS DEO SANIEL GRADE 5
MARK JERON O. MAITEM GRADE 5
VANDROSS FRANCE L. DIONISIO GRADE 5
Sport’s Club Name:
Established Date:
Sports Club Facilitator/s:
Sports Club Member/s:
Members’ Name Grade Level
Sport’s Club Name:
Established Date:
Sports Club Facilitator/s:
Sports Club Member/s:
Members’ Name Grade Level
II. ROGRAMMING
Put the preferred time schedule. Add rows and columns if necessary.
Time Sports Club Mon Tues Wed Thur Fri Sat
s
/ / / / / /
/ / / / / /
/ / / / / /
Put the preferred time schedule. Add rows and columns if necessary.
Time Varsity Club Mon Tues Wed Thur Fri Sat
s
N/A N/A N/A N/A N/A N/A N/A N/A
III. LIST OF AVAILABLE SPORTS EQUIPMENT AND SPORTS FACILITIES
Tick the box if standard sports equipment and facilities are available and ready to use. Put remarks and add
rows if necessary.
Learning Facilities Remarks
Track and field oval N/A
Gymnasium/covered court N/A
Basketball court N/A
Volleyball court N/A
Swimming pool N/A
Football/ softball/ baseball field N/A
Spacious playing area N/A
Others: _______________________
_______________________
_______________________
Sports Equipment Remarks
N/A N/A
IV. SPORTS ACTIVITIES, PROGRAMS AND / OR PROJECTS
Give at least (3) three recent activities, programs, projects or any other initiatives related to sports.
Add rows if necessary.
Activities/ Programs/ Projects Date of Implementation
1. Sports Club Day September
2. Sports Training Camp October
3. Sports Festival November
Declaration:
I hereby declare the information provided in this application is true and correct and there have been no
misleading statements, omission of any relevant facts nor misinterpretation made.
Prepared by:
Sports Club Coordinator TERESITA Y. BAGAL
Signature
Date
Certified by:
Principal/ Office – in - LEONILA D. BERDIN
charge
Signature
Date
Verified by:
Division Sports Officer JOVETH C. TOBIANO
Signature
Date
Noted by:
Schools Governance and MARIO C. MONDEJAR
Operations Divisions
Signature
Date
Approved by:
Schools Division LORENZO E. MENDOZA
Superintendent
Signature
Date
