EWAN KO RIN
EWAN KO RIN
Department of Education
REGION I
SCHOOLS DIVISION OFFICE I PANGASINAN
CALASIAO I DISTRICT
BALANI-PARONGKING ELEMENTARY SCHOOL
SITIO BALANI, AMBONAO, CALASIAO, PANGASINAN
Date: ___________________
PARENTAL CONSENT
I/We, the undersigned, hereby willingly and voluntarily give full consent for my/our
son/daughter, _____________________________, to participate in the 2024 Division Schools Press
Conference in Mangatarem National High School, Mangatarem, Pangasinan from December 5-6,
2024.
I/We have thoroughly considered the potential benefits that my/our child will derive from their
participation in this activity, and I/We fully understand that the personnel of the Department of
Education (DepEd) cannot be held liable for any unforeseen incidents or circumstances beyond their
control. However, I/We have confidence that the DepEd personnel will exercise due care, diligence,
and necessary precautions to ensure the health and safety of my/our son/daughter.
Furthermore, I/We hereby authorize the personnel of the Department of Education to collect,
process, retain, and dispose of the personal information of the aforementioned learner in strict
accordance with the provisions outlined in the Data Privacy Act of 2012.
I/We acknowledge that this consent form remains valid throughout the duration of the
aforementioned event, and I/We understand that I/We have the right to revoke this consent in writing
at any time, provided that sufficient notice is given to the relevant authorities.
By signing below, I/We affirm that I/We have read and understood the contents of this
consent form, and I/We willingly and voluntarily provide our consent as indicated.
Signature of Father Over Printed Name Signature of Mother Over Printed Name
Verified: