Department of Education: Republic of The Philippines

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Republic of the Philippines

Department of Education
Region I
Schools Division of San Carlos City
ANO ELEMENTARY SCHOOL
Ano, San Carlos City, Pangasinan
____________________________________________________________________________________________________

Dear Parent/Guardian:

Greetings!

Please be advised that Ano Elementary School will be having “Moving Up Ceremony” on
July 8, 2022 with the theme Graduweyt ng K to 12:Masigasig sa mga Pangarap at Matatag sa
mgo Pagsubok (K to 12 Graduates: Pursuing Dreams and Fostering Resilience in the Face of
Adversity) @ 1:00 in the afternoon.

To ensure the safety of everyone, the following measures must be strictly observed at all times
during the activity:
a. Face masks must be worn throughout the entire event,
b. At least a one-meter safe distance must be observed between individuals,
c. Participants must be seated at their assigned seats only,
d. Handshake or any other forms of physical contact is discouraged, and
e. Only one parent or one designated guardian shall be permitted to accompany a mover
or candidate for graduation.

Kindly read the full text and affix your signature below if you will give consent to participate
your child/ren in the said activity.

PARENTAL CONSENT

I acknowledge that my child/ren’s participation in this activity is completely


voluntary. While there remains the risk of possible COVID-19 transmission to my child/ren,
and to the members of my household, I freely assume the said risk and I permit my
child/ren to attend under this activity.
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 the school
and its personnel as well as officials and personnel of the Department of Education
relative to the conduct of the activity.
With full understanding, I – on behalf of myself, my household members, and my
child/ren – hereby freely and voluntarily give my consent to my child/ren’s participation in
the activity. I also attest that I had sought the views of my child/ren and he/she has
expressed willingness to participate in the activity.

LEARNER’S NAME:_____________________________

___________________________
NAME OF PARENT/GUARDIAN DATE:___________
(SIGNATURE OVER PRINTED NAME) CONTACT NUMBER:___________

Return this signed form to your child/ren’s adviser.

Address: Ano, San Carlos City, Pangasinan


Telephone No.: 09217934356
Email Address: [email protected]

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