| 1 | GR0237 | NAFADZ HUSEIN TAMAM | 5 | Putra | Futsal |
| 2 | GR0237 | AHMAD KHABIB SAPUTRA | 5 | Putra | Futsal |
| 3 | GR0237 | ANANTA RIZKY SAPUTRA | 5 | Putra | Futsal |
| 4 | GR0237 | ARKA ABDUL FAA'IQ | 5 | Putra | Futsal |
| 5 | GR0237 | M. FARID DERY SAPUTRA | 5 | Putra | Futsal |
| 6 | GR0237 | MUHAMAD DZAKI MAHARDIKA | 5 | Putra | Futsal |
| 7 | GR0237 | MUHAMAD FATICH MASRURI | 5 | Putra | Futsal |
| 8 | GR0237 | MUHAMMAD RIZQI RAMADHAN | 5 | Putra | Futsal |
| 9 | GR0237 | OZIL NOOR IBRAHIM | 5 | Putra | Futsal |
| 10 | GR0237 | MUHAMMAD ARSIL CHA'IQUL AFHAM | 5 | Putra | Futsal |
| 11 | GR0237 | MUHAMMAD RIZQI ANDIKA | 4 | Putra | Futsal |
| 12 | GR0239 | HUSNA KHOIRUNISA | 5 | Putri | Senam Nahdlatul Ulama |
| 13 | GR0239 | INTAN PUJI YULIANA | 5 | Putri | Senam Nahdlatul Ulama |
| 14 | GR0239 | IRFAN HANIF MUAFA | 5 | Putra | Senam Nahdlatul Ulama |
| 15 | GR0239 | LIFIA FARAH TSABITA | 5 | Putri | Senam Nahdlatul Ulama |
| 16 | GR0239 | WARDAH SYAFARIYAH | 5 | Putri | Senam Nahdlatul Ulama |
| 17 | GR0239 | ZIDNY NAZILATAL FAIZAH | 5 | Putri | Senam Nahdlatul Ulama |
| 18 | L2301 | MOHAMMAD IKMALUL IHSAN | 5 | Putra | Catur |
| 19 | L23012 | MUHAMMAD AL FATAH DARMAWAN | 5 | Putra | Kaligrafi |
| 20 | L2302 | SAKHA ALBY RAHMAN | 4 | Putra | Lari Jauh |
| 21 | L2303 | MUHAMMAD SAIFUL ANAM | 5 | Putra | Lari Sprint |
| 22 | P23014 | NASYWA AUFAA AZAHRA | 3 | Putri | MTQ |
| 23 | P23015 | ALYA KHAIRA NUGROHO | 5 | Putri | Puisi Religi (Cipta & Baca) |
| 24 | P23018 | KHOIRUNNISA RIZQIANINGSIH | 3 | Putri | Pidato B. Arab |
| 25 | P23019 | QIRANIA AGISKA MEILANIE | 3 | Putri | Pidato Bahasa Indonesia |
| 26 | P23021 | MILATI ASIH SESAMI | 5 | Putri | Penulisan Biografi Kiai Lokal |
| 27 | P2303 | SELMA ALIFIA KIRANI | 4 | Putri | Lari Sprint |
