Revised as of September 26, 2019

Republic of the Philippines

DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter CEELSTIAN C. CATAN in BASKETBALL BOYS in all
School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

ELIZALDE A. CATAN NORMA C. CATAN

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

MARIVIC B. ONG ORLANDO Y. OMLANG

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter RICKY R. DEIMOS in BASKETBALL BOYS in all
School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

LUIS C. DEIMOS RITA R. DEIMOS

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

MARIVIC B. ONG MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter JHON T. JUSTO in BASKETBALL BOYS in all School
Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

NELSON D. JUSTO JR. JOSEPHINE T. JUSTO

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

LORETA C. TAYKO MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter JENSON RALPH T. REMOLLO in BASKETBALL
BOYS in all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

EMERSON R. REMOLLO JENETTE T. REMOLLO

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

MICHELE S. TABILON MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter JUSTINE DAVE T. TAOL-TAOL in BASKETBALL
BOYS in all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

ESPERATO N. TAOL-TAOL LUZVIMINDA T. TAOL-TAOL

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

LORETA C. TAYKO MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter WAHLEEN N. PINILI in BASKETBALL BOYS in all
School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

WALDEN T. PINILI JENALYN N. PINILI

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

AMY M. SING MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter JOSEPH R. CALLAO JR. in BASKETBALL BOYS in
all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

JOSEPH B. CALLAO ANGELIE R. CALLAO

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

ZHARINA C. SARINAS MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 28, 2019

Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter JHON MAURIS TORRES in BASKETBALL BOYS in all
School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

N/A JOAN C. TORRES

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

MARIVIC B. ONG MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter JEN LOU M. CATALAN in BASKETBALL BOYS in all
School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

LOUIEL A. CATALAN JENIFER JANE M. CATALAN

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

JOVENCIO V. MIRAFUENTES MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter GIAN CARLO CORDERO in BASKETBALL BOYS in
all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

N/A GEMMA CORDERO

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

JOVENCIO V. MIRAFUENTES MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

OCTOBER 9, 2019
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter GIAN CARLO CORDERO in BASKETBALL BOYS in
all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

KENT ALLEN R. DEGUIT VILLA E. DEGUIT

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

JOVENCIO V. MIRAFUENTES MA. GINA S. ANQUI

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
VII
(Region)
DUMAGUETE CITY
(Division)
TACLOBO NATIONAL HIGH SCHOOL
(School)
TACLOBO, DUMAGUETE CITY
(School Address)

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)