PERMIT
PERMIT
PERMIT
Department of Education
Region IV-A CALABARZON
Division of Batangas
District of Calatagan
SANTIAGO ZOBEL ELEMENTARY SCHOOL
Balitoc, Calatagan, BATANGAS
_________________________
Date
PARENTAL CONSENT
I have considered the benefits that my son/daughter will get from his/her
participation in this 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/Date Signature of Mother over
Printed Name/Date
_____________________________________________
Signature of Guardian over Printed Name /Date
___________________________________
Relationship with the Learner
Verified by:
_____________________________________________ Date:
__________________________
Name: _______________________________________________________________________
Grade Level: __________________________________________________________________
Section: ______________________________________________________________________
Age: _________________________________________________________________________
- -------------------------------------------------------
--------------
To be filled out by the Adviser/Learning Area Teacher:
CRLA ______________________
RMA ________________________
Reading ____________________
Mathematics _________________
Name: ____________________________________________________