Republic of the Philippines

DEPARTMENT OF EDUCATION
Region VI – Western Visayas
Division of Antique
SIBALOM CENTRAL ELEMENTARY SCHOOL

_____________________
Date

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

I/We hereby willingly and voluntarily give consent for my/our son/daughter
_____________________________________________________ to attend his/her
remedial classes in ICT – Computer Programming. This is to comply with his/her lacking
requirements in order to pass the subject.

I have considered the significance of my son’s/daughter’s attendance to the

remedial classes and so, I/we allow him/her to participate despite the order that
individuals below 21 years old are not allowed to travel unless the purpose is essential,
provided that due care and precautions 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

Signature of Guardian over Printed name

(Relationship with the Athlete)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
Region VI – Western Visayas
Division of Antique
SIBALOM CENTRAL ELEMENTARY SCHOOL

_____________________
Date

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

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter _____________________________________________________ in the
Division, Regional Meet and Palarong Pambansa.

I have considered the benefits that my son or 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

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

__________________________________________________
Teacher-Adviser/School Head/Registrar

Remarks: