Republic of the Philippines

Department of Education
REGION X
SCHOOLS DIVISION OF MISAMIS OCCIDENTAL

PARENTAL CONSENT AND WAIVER FORM

I, ______________________________________, as the parent or legal guardian of

_________________________________________, hereby acknowledge that I have been
informed of the details of the conduct of the face-to-face event of the Brigada
Eskwela Activities for School Year 2025-2026 which will be held on June 09-13,
2025, at our respective school _________________________________and hereby state/
declare that:
1. I give Full Consent for our child/ward _______________ to participate in the
Brigada Eskwela Activities for SY 2025-2026 on June 09-13, 2025 at our
respective school;
2. I acknowledge that I have been informed of the details of the invitation to
participate in the Brigada Eskwela Activities for SY 2025-2026;
3. I understand that my child/ward’s in-person attendance at the event will
include associating with teachers, fellow learners and school personnel, and
other persons inside and outside of the school that may put my child of
transmission of any communicable disease, notwithstanding the precautions
undertaken by the implementing team to avoid such transmission;
4. I acknowledge that our child’s participation in this activity is completely
voluntary, and he/she may decline to participate at any time for any reason.
While there remains the risk of possible transmission of any communicable
diseases to my child/ward, and to the members of my household, I freely
assume the said risk and I permit my child/ward to attend this activity;
5. To the best of my knowledge, my child/ward is in good physical condition,
and I confirm that he/she does not have any symptoms for communicable
disease;
6. I will not allow our child/ward to participate in the Brigada Eskwela Activities
for SY 2025-2026, if he/she or any member of my household develops any of
the said symptoms or any other symptoms of illness that may or may not be
related to any communicable disease. I will also inform the school/division
and not allow my child/ward to attend the Brigada Eskwela Activities for SY
2025-2026, if he/she or any members of my household test positive for any
communicable disease;
7. I give full permission in any recording or picture taken of my child/ward
during the conduct of Brigada Eskwela Activities for SY 2025-2026, and to
use for purposes of documentation my child’s/ward’s images, contribution,
or performance in any publication created by or for the BLSS-YFD and to

Address: Osilao St., Poblacion 1, Oroquieta City, Misamis Occidental

Contact Number: (088) 531-4026
E-mail Address: [email protected]
Website: https://depedmisocc.info
 Republic of the Philippines
Department of Education
REGION X
SCHOOLS DIVISION OF MISAMIS OCCIDENTAL

release this material to DepEd official platforms in accordance with the

provisions of Republic Act No. 10173 otherwise known as the Data Privacy
Act of 2012;
8. I conform/agree to the collection and/or processing of any personal
information and data from myself and my child/ward, that are necessary to
successfully conduct the Brigada Eskwela Activities for SY 2025-2026, in
accordance with the provisions of Republic Act No. 10173 otherwise known
as the Data Privacy Act of 2012;
2. I agree and understand the commitment of my child/ward as a participant
and will support his/her endeavor to meet the expectations, guidelines, and
responsibilities with his/her fellow participants and to DepEd;
3. To the extent allowed by law and rules, I hereby agree to waive, release, and
discharge any and all claims, causes of action, damages and rights against
DepEd relative to the conduct of the activity;
4. With full understanding, I hereby freely and voluntarily give my consent to my
child/ward’s participation in the activity. I also attest that I had sought the
views of my child, and he/she has expressed a willingness to participate in
the activity; and
5. By signing below, I acknowledge and represent that I have read this
document, took time to understand it, and eventually signed it voluntarily as
my own free act and deed.

Signed this ________ day of ________ 2025 at ____________________________________,

Philippines.

Signature over Printed Name of Contact Details (Mobile Number)

Parent/Guardian

Name of Child/Ward Date

Address Home/Mobile Number

Address: Osilao St., Poblacion 1, Oroquieta City, Misamis Occidental

Contact Number: (088) 531-4026
E-mail Address: [email protected]
Website: https://depedmisocc.info
 Republic of the Philippines
Department of Education
REGION X
SCHOOLS DIVISION OF MISAMIS OCCIDENTAL

LEARNER-PARTICIPANT CONSENT, WAIVER, INDEMNITY and RELEASE

I, ______________________________________, agreed to participate with the consent of

my parents and/or legal guardian in the conduct of Brigada Eskwela Activities for
SY 2025-2026 in my respective school ___________________________ and hereby
state/declare that:

1. I give permission to the DepEd and its representatives to make recordings of

my voice and to take photographs and/or videos in which I appear in, to be
used for the communications and various public campaigns of the Agency be
it in print, broadcast, and/or electronic media, at the event and location
stated above subject to limitations of applicable and relevant laws, rules, and
regulations.
2. I conform/agree to the collection and/or processing of any personal
information and data, that are necessary to the conduct of Brigada Eskwela
Activities for SY 2025-2026, in accordance with the provisions of Republic Act
No. 10173 otherwise known as the Data Privacy Act of 2012.
3. I have read and understood completely the accompanying letter and
information leaflet and therefore know the purpose of the project/activity and
my participation.
4. With full understanding, I hereby freely and voluntarily give my consent to my
participation in the activity.

Signature over Printed Name of Name of School

Learner-Participant

Age Date

Address Home/Mobile Number

Address: Osilao St., Poblacion 1, Oroquieta City, Misamis Occidental

Contact Number: (088) 531-4026
E-mail Address: [email protected]
Website: https://depedmisocc.info