Scribd
Upload
17 views

2020 Parents Consent Revised 2

This document is a parental consent form from Aclan Elementary School in Agusan del Norte, Philippines. It gives consent for a student to participate in school sports competitions up to the Palarong Pambansa national games. The form must be signed by parents and verified by the student's adviser and school head. It also authorizes the Department of Education to handle the student's personal information according to the Data Privacy Act.

Uploaded by

Lynet Sumabal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
17 views

2020 Parents Consent Revised 2

This document is a parental consent form from Aclan Elementary School in Agusan del Norte, Philippines. It gives consent for a student to participate in school sports competitions up to the Palarong Pambansa national games. The form must be signed by parents and verified by the student's adviser and school head. It also authorizes the Department of Education to handle the student's personal information according to the Data Privacy Act.

Uploaded by

Lynet Sumabal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
You are on page 1/ 6

Republic of the Philippines

Revised as of September 26, 2019


DEPARTMENT OF EDUCATION
CARAGA
(Region)
AGUSAN DEL NORTE
(Division)
ACLAN ELEMENTARY SCHOOL
(School)
DISTRICT-2, ACLAN, NASIPIT, AGUSAN DEL NORTE
(School Address)

November 10, 2023

PARENTAL CONSENT

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


my/our son/daughter _____________________________ in
_______________ 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.

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

Verified:

ARMILYN P. YONSON MILAGROS P. CASERES, Ed.D.


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)


Revised as of September 26, 2019
Republic of the Philippines
DEPARTMENT OF EDUCATION
CARAGA
(Region)
AGUSAN DEL NORTE
(Division)
ACLAN ELEMENTARY SCHOOL
(School)
DISTRICT-2, ACLAN, NASIPIT, AGUSAN DEL NORTE
(School Address)

November 10, 2023

PARENTAL CONSENT

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


my/our son/daughter _____________________________ in
_______________ 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.

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

Verified:

ARLENE L. CURAZA MILAGROS P. CASERES, Ed.D.


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
Revised as of September 26, 2019
DEPARTMENT OF EDUCATION
CARAGA
(Region)
AGUSAN DEL NORTE
(Division)
ACLAN ELEMENTARY SCHOOL
(School)
DISTRICT-2, ACLAN, NASIPIT, AGUSAN DEL NORTE
(School Address)

November 10, 2023

PARENTAL CONSENT

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


my/our son/daughter _____________________________ in
_______________ 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.

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

Verified:

ARLENE N. BURATO MILAGROS P. CASERES, Ed.D.


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)


Revised as of September 26, 2019
Republic of the Philippines
DEPARTMENT OF EDUCATION
CARAGA
(Region)
AGUSAN DEL NORTE
(Division)
ACLAN ELEMENTARY SCHOOL
(School)
DISTRICT-2, ACLAN, NASIPIT, AGUSAN DEL NORTE
(School Address)

November 10, 2023

PARENTAL CONSENT

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


my/our son/daughter _____________________________ in
_______________ 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.

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

Verified:

CORINA M. SIMBAJON MILAGROS P. CASERES, Ed.D.


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
Revised as of September 26, 2019
DEPARTMENT OF EDUCATION
CARAGA
(Region)
AGUSAN DEL NORTE
(Division)
ACLAN ELEMENTARY SCHOOL
(School)
DISTRICT-2, ACLAN, NASIPIT, AGUSAN DEL NORTE
(School Address)

November 10, 2023

PARENTAL CONSENT

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


my/our son/daughter _____________________________ in
_______________ 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.

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

Verified:

ARMILYN P. YONSON MILAGROS P. CASERES, Ed.D.


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)


Revised as of September 26, 2019
Republic of the Philippines
DEPARTMENT OF EDUCATION
CARAGA
(Region)
AGUSAN DEL NORTE
(Division)
ACLAN ELEMENTARY SCHOOL
(School)
DISTRICT-2, ACLAN, NASIPIT, AGUSAN DEL NORTE
(School Address)

November 10, 2023

PARENTAL CONSENT

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


my/our son/daughter _____________________________ in
_______________ 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.

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

Verified:

ARMILYN P. YONSON MILAGROS P. CASERES, Ed.D.


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)

You might also like