SCHOOLS DIVISION OFFICE OF COTABATO

Matalam South District

MATALAM CENTRAL ELEMENTARY SCHOOL
POBLACION, MATALAM, COTABATO

Annex 2. Parent/Legal Guardian Consent Form

____________________
Date
PARENTAL CONSENT

I, We, hereby willingly and voluntarily give consent to the participation of my son/daughter
_________________________________________, in the National Learning Camp from July 3-4, 9-11, 16-18, 2024.

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: ____________________________
Teacher
Note: If not Parent/s, submit Affidavit of Guardianship duly verified by the Teacher

SCHOOLS DIVISION OFFICE OF COTABATO

Matalam South District
MATALAM CENTRAL ELEMENTARY SCHOOL
POBLACION, MATALAM, COTABATO

Annex 2. Parent/Legal Guardian Consent Form

____________________
Date
PARENTAL CONSENT

I, We, hereby willingly and voluntarily give consent to the participation of my son/daughter
_________________________________________, in the National Learning Camp from July 3-4, 9-11, 16-18, 2024.

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: ____________________________
Teacher
Note: If not Parent/s, submit Affidavit of Guardianship duly verified by the Teacher
 SCHOOLS DIVISION OFFICE OF COTABATO
Matalam South District
MATALAM CENTRAL ELEMENTARY SCHOOL
POBLACION, MATALAM, COTABATO

Annex 1. The National Learning Camp Registration Template

Name: __________________________________________________________ Date:____________________________________

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 results in: CRLA _________________________ RMA _______________________

Recommended Camp Placement:

Intervention: ________ Consolidation: _____________ Enhancement: _________________

Teacher Adviser in the current enrolled Grade Level:

Name: ________________________________________________________ Contact Number: __________________

SCHOOLS DIVISION OFFICE OF COTABATO

Matalam South District
MATALAM CENTRAL ELEMENTARY SCHOOL
POBLACION, MATALAM, COTABATO

Annex 1. The National Learning Camp Registration Template

Name: __________________________________________________________ Date:____________________________________

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 results in: CRLA _________________________ RMA _______________________

Recommended Camp Placement:

Intervention: ________ Consolidation: _____________ Enhancement: _________________

Teacher Adviser in the current enrolled Grade Level:

Name: ________________________________________________________ Contact Number: __________________

 SCHOOLS DIVISION OFFICE OF COTABATO
Matalam South District
MATALAM CENTRAL ELEMENTARY SCHOOL
POBLACION, MATALAM, COTABATO

Appendix D of Annex 3. Registry of Learning Camp Volunteers

School: MATALAM CENTRAL ELEMENTARY SCHOOL SDO: COTABATO

Region: XII School ID: 130162
Complete School Address: Millare St., Poblacion, Matalam, Cotabato

Registry of Learning Camp Volunteer for Reading Grades 1 to 3

Tick (√ ) the Volunteer Category
NAME SPECIALIZATION Non-DepEd DepEd

Registry of Learning Camp Volunteer for Mathematics Grades 1 to 3

Tick (√ ) the Volunteer Category
NAME SPECIALIZATION Non-DepEd DepEd
 SCHOOLS DIVISION OFFICE OF COTABATO
Matalam South District
MATALAM CENTRAL ELEMENTARY SCHOOL
POBLACION, MATALAM, COTABATO

SAMPLE DAILY CLASS PROGRAM FOR GRADE 3

Intervention Camp

From To No. of Minutes Activity

8:00 8:05 5 Movement to Class
8:05 8”:50 45 Lesson 1 Reading
8:50 8:55 10 Class Break
8:55 9:40 45 Lesson 2 Reading
9:40 10:00 20 Recess
10:00 10:45 45 Lesson 3 Reading
10:45 10:50 5 Class Break
10:50 11:35 45 Lesson 1 Mathematics
11:35 12:35 60 Lunch Break
12:35 1:20 45 Lesson 2 Mathematics
1:20 1:25 5 Class Break
1:25 2:10 45 Lesson 3 Mathematics
2:10 Onward Camp-like Interest Activities

Prepared by: Checked by:

____________________ JULIE S. PASCUAL

Learning Camp Volunteer Principal-II

APPROVED:
JOSEPHINE C. LORILLA
Public Schools District Supervisor
 SCHOOLS DIVISION OFFICE OF COTABATO
Matalam South District
MATALAM CENTRAL ELEMENTARY SCHOOL
POBLACION, MATALAM, COTABATO

LIST OF ELEMENTARY SCHOOL CAMPERS

Grade 1 Intervention Camp
NLC 2024

N MALE No FEMALE
o

Prepared by: Noted:

_________________________ JULIE S. PASCUAL
T-III/NLC Volunteer Principal -II
 District Orientation on
National Learning Camp
PROGRAM
Part I. Registration (7:30-8:00) PMT
Part II. Opening Program
National Anthem AVP
Prayer AVP
Welcome Address & Mrs. Meriam Pecaoco
Opening Remarks MHS Assistant Principal
Recognition of Participants Alvin Gumapac, MT-1
TIC, Estado ES
Statement of Purpose Josephine C. Lorilla
Public Schools District Supervisor
Closing Remarks Tita P. Raya, EdD