PERMIT

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Republic of the Philippines

Department of Education
Region IV-A CALABARZON
Division of Batangas
District of Calatagan
SANTIAGO ZOBEL ELEMENTARY SCHOOL
Balitoc, Calatagan, BATANGAS

Annex 2. Parent/Legal Guardian Consent Form

_________________________
Date

PARENTAL CONSENT

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


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 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:
__________________________

Santiago Zobel Elementary School, Balitoc, Calatagan, Batangas


09190021628/ 09301699028
[email protected]
 DepEd Tayo Santiago Zobel Elementary School-Batangas Province
Republic of the Philippines
Department of Education
Region IV-A CALABARZON
Division of Batangas
District of Calatagan
SANTIAGO ZOBEL ELEMENTARY SCHOOL
Balitoc, Calatagan, BATANGAS
Teacher

Note: If No Parent/s, submit an Affidavit of Guardianship duly verified by the teacher.

Annex 1: The National Learning Camp Registration Template

Name: _______________________________________________________________________
Grade Level: __________________________________________________________________

Section: ______________________________________________________________________
Age: _________________________________________________________________________

Residential Address: ___________________________________________________________


Parent/Guardian:
Name: __________________________________________

Contact Number: _________________________________

- -------------------------------------------------------
--------------
To be filled out by the Adviser/Learning Area Teacher:

If Grade 1 to 3, assessment result in:

CRLA ______________________
RMA ________________________

Recommended Camp Placement:

Reading ____________________
Mathematics _________________

Teacher Adviser in the currently enrolled Grade Level:

Name: ____________________________________________________

Contact Number: __________________________________________

Santiago Zobel Elementary School, Balitoc, Calatagan, Batangas


09190021628/ 09301699028
[email protected]
 DepEd Tayo Santiago Zobel Elementary School-Batangas Province

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