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2020 - Parents Consent - Revised-2

The document is a parental consent form from St. Anthony Academy of Mondragon Northern Samar for a student to participate in school sports meets up to the Palarong Pambansa. Parents sign to give consent and authorize personal information collection according to the Data Privacy Act. Spaces are provided for signatures of father, mother, adviser, and school head.

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Resty Egang
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25 views1 page

2020 - Parents Consent - Revised-2

The document is a parental consent form from St. Anthony Academy of Mondragon Northern Samar for a student to participate in school sports meets up to the Palarong Pambansa. Parents sign to give consent and authorize personal information collection according to the Data Privacy Act. Spaces are provided for signatures of father, mother, adviser, and school head.

Uploaded by

Resty Egang
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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Revised as of September 26,

2019 Republic of the Philippines


DEPARTMENT OF EDUCATION
VIII
(Region)
NORTHERN SAMAR
(Division)
St. Anthony Academy of Mondragon
(School)
Brgy. Chitongco, Mondragon Northern Samar
(School Address)

Republic of the Philippines

Department of Education
Region VIII

SCHOOLS DIVISION OF NORTHERN SAMAR

ST. ANTHONY ACADEMY OF MONDRAGON NORTHERN SAMAR

_____________________
Date

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:

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)

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