SCHOOLS DIVISION OFFICE

School District VII

PAYATAS B ELEMENTARY SCHOOL
2nd District, Quezon City, Metro Manila

PARENT/GUARDIAN CONSENT FORM

SUMMER READING CAMP
ACROSS ALL LEARNING AREAS 2018

TO WHOM IT MAY CONCERN:

This is to certify that I allowed my son / daughter to join the 2018 SUMMER READING CAMP.

DATE OF ACTIVITY: April 25 – May 2, 2018 8:00 a.m. – 5: 00 p.m.

PLACE OF ACTIVITY: PAYATAS B ELEMENTARY SCHOOL

NAME OF SON/DAUGHTER

GRADE

Thank you very much!

Yours truly,

__________________________________ APPROVED:

NAME OF STUDENT __________________________

(Signature Over Printed Name) NAME OF PARENT / GUARDIAN

(Signature Over Printed Name)

STUDENT WAIVER

I, ______________________________________________(NAME) presently enrolled in

__________________________________________________________________(NAME OF SCHOOL)
____________________________________________(GRADE) present myself to join the 2018 SUMMER
READING CAMP as part of our school/student activity and do hereby pledge that:

1. I will obey the rules and regulations promulgated, enforced by the PAYATAS B ELEMENTARY SCHOOL for the
protection and safety of all;

2. That I hereby waived and renounce my rights to all damages, hospitalization, and the like and I will not hold the
school of MUST responsible for any misfortune, injury, or accident be slight or serious, that may happen in connection
with the activities or requirements. The cause of which will be attributable to my acts of my disobedience, negligence,
and the offense of my heading to advice, warning, precaution, and safety rules that were read to me by my TEACHER-
FACILITATOR before the start of the activity. That the content of this waiver was read and explained to me before I affix
my name and signature this ______ day of ______________freely and voluntarily.

Thank you very much!

Yours truly,

APPROVED:

__________________________ __________________________

Name of Student Name of Parent/ Guardian

(Signature-Over-Printed Name) (Signature-Over-Printed Name)

 SCHOOLS DIVISION OFFICE
School District VII
PAYATAS B ELEMENTARY SCHOOL
2nd District, Quezon City, Metro Manila

SUMMER READING CAMP

ACROSS ALL LEARNING AREAS 2018

DAY 5 ATTENDANCE MAY 2

NAME GRADE TIME IN TIME OUT
 SCHOOLS DIVISION OFFICE
School District VII
PAYATAS B ELEMENTARY SCHOOL
2nd District, Quezon City, Metro Manila

Presents this

Certificate of Participation
to

______________________________________________
for his/her active participation and involvement
during the SUMMER READING CAMP Acroos All Learning Areas
held at Payatas B Elementary School from April 25 to May 3 2018.
Given this 3rd day of May, 2018 at
Payatas B Elementary School, Grp. 1 Narra St Brgy. Payatas,
Quezon City, Metro Manila.

CATHERINE L. RENANTE ERWIN B. SE BRYAN P. CHENILLA

ENGLISH FACILITATOR MATH FACILITATOR GUIDANCE FACILITATOR

ROXANNE F. ALPAJANDO TERESITA B. CORREO ELIZABETH P. LORENZANA

MAPEH FACILITATOR SIGN LANGUAGE FACILITATOR CAMP CHAIRMAN

JAY V. URETA, Ed.D

PRINCIPAL
SCHOOLS DIVISION OFFICE
School District VII
PAYATAS B ELEMENTARY SCHOOL
2nd District, Quezon City, Metro Manila

Presents this

Certificate of Participation
to

______________________________________________
for his/her active participation and involvement
during the SUMMER READING CAMP Acroos All Learning Areas
held at Payatas B Elementary School from April 25 to May 3 2018.
Given this 3rd day of May, 2018 at
Payatas B Elementary School, Grp. 1 Narra St Brgy. Payatas,
Quezon City, Metro Manila.

CATHERINE L. RENANTE ERWIN B. SE BRYAN P. CHENILLA

ENGLISH FACILITATOR MATH FACILITATOR GUIDANCE FACILITATOR

ROXANNE F. ALPAJANDO TERESITA B. CORREO ELIZABETH P. LORENZANA

MAPEH FACILITATOR SIGN LANGUAGE FACILITATOR CAMP CHAIRMAN

JAY V. URETA, Ed.D

PRINCIPAL
 SUMMER
READING
CAMP
ACROSS
ALL
LEARNING
AREAS 2018
 SUMMER
READING
CAMP
ACROSS
ALL
LEARNING
AREAS 2018
 SUMMER
READING
CAMP
ACROSS
ALL
LEARNING
AREAS 201
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