Republic of the Philippines

Department of Education
Region XII
Division of City Schools of Koronadal
Koronadal District II
KORONADAL CENTRAL ELEMENTARY SCHOOL II
Brgy. Zone IV, City of Koronadal
School ID # 131407

November 24, 2017

Date

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

I hereby willingly and voluntarily give consent to the participation of my

son/daughter ______________________________ in the 2017 Regional Schools
Press Conference to be held in Midsayap, Cotabato on November 26-29, 2017.

I have considered the benefits that my son/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 Parent

Name of Parent

Verified by :

MA. THERESA P. YANSON

Principal I
 Republic of the Philippines
Department of Education
Region XII
Division of City Schools of Koronadal
Koronadal District II
KORONADAL CENTRAL ELEMENTARY SCHOOL II
Brgy. Zone IV, City of Koronadal
School ID # 131407

November 24, 2017

Date

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

I hereby willingly and voluntarily give consent to the participation of my

son/daughter ______________________________ in the 2017 Regional Schools
Press Conference to be held in Midsayap, Cotabato on November 26-29, 2017.

I have considered the benefits that my son/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

Verified by :

MA. THERESA P. YANSON

Principal I
 MEDICAL CERTIFICATE

__________________
(Date)

To Whom It May Concern:

This is to certify that I have personally examined CHRISTIAR L. CASTOR ,

Name

age 12 , sex male, born on August 15, 2004 and have found that he is

physically fit, during the time of examination, to join and compete in the 2017

National Schools Press Conference.

Event: Editorial Cartooning ( Elementary – English )

Physical Examination

Date examined: _______________

Height Weight: Blood Pressure

Pulse, Resting Respiratory

Rate
Other Remarks:

____________________________
Physician/Medical Officer
(Signature over printed name)

License No. __________________

PTR.: ____________________
Date: ____________________
 MEDICAL CERTIFICATE

__________________
(Date)

To Whom It May Concern:

This is to certify that I have personally examined JOEVER P. RAFAEL ,

Name

age 12 , sex male, born on September 3, 2004 and have found that he is

physically fit, during the time of examination, to join and compete in the 2017

National Schools Press Conference.

Event: Editorial Cartooning ( Elementary – Filipino )

Physical Examination

Date examined: _______________

Height Weight: Blood Pressure

Pulse, Resting Respiratory

Rate
Other Remarks:

____________________________
Physician/Medical Officer
(Signature over printed name)

License No. __________________

PTR.: ____________________
Date: ____________________