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Sample Parental Consent and Waiver Form

This document contains three parental consent and waiver forms for students participating in the Division School Press Conference activities in January and February 2024. The forms give consent for the students' participation, note the benefits to students, and waive responsibility of schools for incidents beyond their control. The forms are signed by parents and school officials.

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Jessica Crisostomo
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529 views

Sample Parental Consent and Waiver Form

This document contains three parental consent and waiver forms for students participating in the Division School Press Conference activities in January and February 2024. The forms give consent for the students' participation, note the benefits to students, and waive responsibility of schools for incidents beyond their control. The forms are signed by parents and school officials.

Uploaded by

Jessica Crisostomo
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE

PARENTAL CONSENT AND WAIVER FORM

TO WHOM IT MAY CONCERN:

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


son/daughter ALLIAH VERONIKHA R. FLORAGUE to attend in the contest activities
of the Division School Press Conference Semifinal Round at Tarlac National HS and
Jose V. Yap HS / Final Round at Tarlac National HS (Underline the activity) on
January 25, 2024, Final Round: February 8-10, 2024.

I/We have considered the benefits that my son/daughter will derive from his/her
participation in this activity provided that due care and precaution will be observed by
the implementers/coaches to ensure the comfort and safety of my son/daughter and
that the school, district, or division/DTWG, may not be held responsible for any
untoward incident that may happen beyond their control.
I have provided complete and correct information on this form. By signing this
form, I confirm that I have fully informed myself of the contents of this Parental
Consent and Waiver Form by reading it before I signed it.
This consent is signed this 22nd day of January 2024.

MICHAEL FLORAGUE KATRINA LOI FLORAGUE


Parent Parent
Signature Over Printed Name Signature Over Printed Name

JESSICA B. CRISOSTOMO FRANCISCO A. SANTIANO


School Paper Adviser/Teacher-Coach School Head
Signature Over Printed Name Signature Over Printed Name
Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE

PARENTAL CONSENT AND WAIVER FORM

TO WHOM IT MAY CONCERN:

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


son/daughter PRESCIOUS COLEEN D. DELA PEÑA to attend in the contest activities
of the Division School Press Conference Semifinal Round at Tarlac National HS and
Jose V. Yap HS / Final Round at Tarlac National HS (Underline the activity) on
January 25, 2024, Final Round: February 8-10, 2024.

I/We have considered the benefits that my son/daughter will derive from his/her
participation in this activity provided that due care and precaution will be observed by
the implementers/coaches to ensure the comfort and safety of my son/daughter and
that the school, district, or division/DTWG, may not be held responsible for any
untoward incident that may happen beyond their control.
I have provided complete and correct information on this form. By signing this
form, I confirm that I have fully informed myself of the contents of this Parental
Consent and Waiver Form by reading it before I signed it.
This consent is signed this 22nd day of January 2024.

RONALDO DELA PEÑA MARICON DAVID


Parent Parent
Signature Over Printed Name Signature Over Printed Name

MELQUIADEZ S. MANALO, JR. FRANCISCO A. SANTIANO


School Paper Adviser/Teacher-Coach School Head
Signature Over Printed Name Signature Over Printed Name
Republic of the Philippines
Department of Education
REGION III
SCHOOLS DIVISION OF TARLAC PROVINCE

PARENTAL CONSENT AND WAIVER FORM

TO WHOM IT MAY CONCERN:

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


son/daughter PRINCE BJ D. MEJIA to attend in the contest activities of the Division
School Press Conference Semifinal Round at Tarlac National HS and Jose V. Yap
HS / Final Round at Tarlac National HS (Underline the activity) on January 25,
2024, Final Round: February 8-10, 2024.

I/We have considered the benefits that my son/daughter will derive from his/her
participation in this activity provided that due care and precaution will be observed by
the implementers/coaches to ensure the comfort and safety of my son/daughter and
that the school, district, or division/DTWG, may not be held responsible for any
untoward incident that may happen beyond their control.
I have provided complete and correct information on this form. By signing this
form, I confirm that I have fully informed myself of the contents of this Parental
Consent and Waiver Form by reading it before I signed it.
This consent is signed this 22nd day of January 2024.

BOYET MEJIA JULIETA MEJIA


Parent Parent
Signature Over Printed Name Signature Over Printed Name

CLARISSE ANNE C. SAMPANG FRANCISCO A. SANTIANO


School Paper Adviser/Teacher-Coach School Head
Signature Over Printed Name Signature Over Printed Name

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