Parent Consent

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Republic of the Philippines

Department of Education
Region IX, Zamboanga Peninsula
Division of Zamboanga del Norte

KIPIT AGRO- FISHERY HIGH SCHOOL


Kipit, Labason, Zamboanga del Norte

Parent/Legal Guardian Consent Form


SY 2023 – 2024

___________________________
Date

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


daughter ______________________________ (name of learner) in the National Learning
Camp from July 2 to 4, 9 to 11 and 16 to 18.

I have considered the benefits that my son/daughter will get from her
participation in the activity provided that due care and precaution will be observed to
ensure the comfort and safety of my son/ daughter and that DepEd employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.

______________________________ _______________________________
Signature of Father over Printed Name Signature of Mother over Printed Name
Date Signed: _________________ Date Signed: ____________________

____________________________________
Signature of Guardian over Printed Name
Date Signed: _____________________

_________________________________
Relationship with the Learner

Verified by:

________________________________ Date Signed: __________


Teacher

Note: If no parent/s submit an Affidavit of Guardianship duly verified by the teacher.

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