Republic of the Philippines

DEPARTMENT OF EDUCATION
______MIMAROPA________
(Region)
______CALAPAN CITY_________
(Division)
_CANUBING I, CALAPAN CITY___
(School)
___CANUBING I, CALAPAN CITY___
(School Address)

_____________________
Date

P A R E N TA L C O N S E N T

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter _____________________________________________________ in the
2024 Intramurals at Canubing National High School on September 28, 2024 Saturday.

I have considered the benefits that my son or daughter will derive 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 Signature of Mother

Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

__________________________________________________
Teacher-Adviser/School Head/Registrar

Contact Number:
Republic of the Philippines
DEPARTMENT OF EDUCATION
______MIMAROPA________
(Region)
______CALAPAN CITY_________
(Division)
_CANUBING I, CALAPAN CITY___
(School)
___CANUBING I, CALAPAN CITY___
(School Address)

_____________________
Date

P A R E N TA L C O N S E N T

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter _____________________________________________________ in the
2024 Intramurals at Canubing National High School on September 28, 2024 Saturday.

I have considered the benefits that my son or daughter will derive 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 Signature of Mother

Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

__________________________________________________
Teacher-Adviser/School Head/Registrar

Contact Number:
Republic of the Philippines
DEPARTMENT OF EDUCATION
______MIMAROPA________
(Region)
______CALAPAN CITY_________
(Division)
_CANUBING I, CALAPAN CITY___
(School)
___CANUBING I, CALAPAN CITY___
(School Address)

_____________________
Date

P A R E N TA L C O N S E N T

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter _____________________________________________________ in the
2024 Intramurals at Canubing National High School on September 28, 2024 Saturday.

I have considered the benefits that my son or daughter will derive 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 Signature of Mother

Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

__________________________________________________
Teacher-Adviser/School Head/Registrar

Contact Number:
Republic of the Philippines
DEPARTMENT OF EDUCATION
______MIMAROPA________
(Region)
______CALAPAN CITY_________
(Division)
_CANUBING I, CALAPAN CITY___
(School)
___CANUBING I, CALAPAN CITY___
(School Address)
_____________________
Date

P A R E N TA L C O N S E N T

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter _____________________________________________________ in the
2024 Intramurals at Canubing National High School on September 28, 2024 Saturday.

I have considered the benefits that my son or daughter will derive 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 Signature of Mother

Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

__________________________________________________
Teacher-Adviser/School Head/Registrar

Contact Number: