Revised as of September 26, 2019
Republic of the Philippines
DEPARTMENT OF EDUCATION
__________II_________
(Region)
_______ISABELA________
(Division)
____ANDABUEN NATIONAL HIGH SCHOOL______
(School)
___P1, Andabuen, Benito Soliven, Isabela___
(School Address)
_______________
Date
PARENTAL CONSENT
I/We hereby willingly and voluntarily give consent to the participation of
my/our son ________ __, in ____ _____ in all School Sports Meets up to the
Palarong Pambansa.
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 the 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
(Signature Over Printed Name)
Remarks:
Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.
FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)