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Republic of Philippines

Department of Education
National Capital Region – NCR
Division of Marikina

STA. ELENA HIGH SCHOOL

September 11, 2019

This is to certify that I am allowing my son/daughter _________________________________________


to join the PISTA NG MGA PELIKULANG PILIPINO (FILM VIEWING) on September 13, 2019, from
12:30pm until 4pm at ROBINSONS METRO EAST. It is understood that my son/daughter shall abide
by the rules and regulations that may be imposed by the teacher-in-charge of the activity for the
welfare and safety of the group. It is further understood that I fully agree to waive any responsibility on
the part of Sta. Elena High School and the teacher-in-charge in case of any untoward incident happens
to my son/daughter during the entire duration of the educational trip.

________________________
Parent/Guardian’s Signature

(*Kindly attached a photocopy of ID matching signature together with school’s letter of permission
signed by the Department and the Principal)

Republic of Philippines
Department of Education
National Capital Region – NCR
Division of Marikina

STA. ELENA HIGH SCHOOL

September 11, 2019

This is to certify that I am allowing my son/daughter _________________________________________


to join the PISTA NG MGA PELIKULANG PILIPINO (FILM VIEWING) on September 13, 2019, from
12:30pm until 4pm at ROBINSONS METRO EAST. It is understood that my son/daughter shall abide
by the rules and regulations that may be imposed by the teacher-in-charge of the activity for the
welfare and safety of the group. It is further understood that I fully agree to waive any responsibility on
the part of Sta. Elena High School and the teacher-in-charge in case of any untoward incident happens
to my son/daughter during the entire duration of the educational trip.

________________________
Parent/Guardian’s Signature
(*Kindly attached a photocopy of ID matching signature together with school’s letter of permission
signed by the Department and the Principal)

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