VARSITY FORM
AY 2024 - 2025
PASTE
RECENT 2”X 2”
Photo of Student
PERSONAL INFORMATION
Name: ______________________________________________________________
Last Name Given Name Middle Name
Grade Level and Section: ______________________________ Sports Event: ________________________________
Age: ______ Date of Birth: ____________ Religion:____________ Nationality: ______________________
Address: _______________________________________________________ Email Address: ___________________
_______________________________________________________________ Contact Number: _________________
_______________________________________________________________ Height: ________ Weight: ________
B. CONSENT FORM
To the Principal:
I, the parent/guardian of _______________________________ of ______________________________
(Name of the Student) (Grade Level and Section)
do hereby grant permission to our son to join the _______________________ of Lourdes School of Mandaluyong
(Varsity Team – Group)
for Academic Year 2024-2025. We further give our consent to his participation in all LSM-sanctioned trainings, practices,
games and competitions sponsored by various organizations.
_____________________________ _________________
Signature of Parent/Guardian Date
_____________________________
Printed Name of Parent/Guardian
Note: Please submit the student-athlete's medical clearance along with this form.
