Republic of the Philippines
DEPARTMENT OF EDUCATION
________________________
(Region)
__________________________ School
(Division) Logo
(School)
____ ____
(School Address)
Date
PARENTAL CONSENT
I/We hereby willingly and voluntarily give consent to the participation of
my/our son/daughter in in
(Name of athlete) (Sport event)
School Intramural Meet.
I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.
Further, I/We authorize the personnel of Department of Education to
collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.
Signature of Father Over Printed Name Signature of Mother Over Printed Name
Verified:
Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)
Remarks: