Department of Education REGION III CITY OF SAN JOSE DEL MONTE CSJDM NATIONAL SCIENCE HIGH SCHOOL ECOPARK, BRGY. MUZON, CSJDM, BULACAN
PARENTAL CONSENT Date: NOVEMBER 20, 2024
To Whom It May Concern:
I/We hereby willingly and voluntarily give consent to the participation of my/ our son/daughter in 0 in all School Sports Meets up to the Palarong Pambansa. I/We have considered the benefits that my son or daughter will derive from his/her participation in this activity provided that due care, diligence and necessary precautions will be observed to ensure his/her health and safety.
Further, I/We authorize the personnel of Department of Education to collect,
process, retain, and dispose of personal information of the above-mentioned athlete in accordance with the Data Privacy Act of 2012.
0 0 Signature of Father Over Printed Name Signature of Mother Over Printed Name
Verified: 0 DAISY D.C. IFURONG Adviser School Head/Registrar (Signature Over Printed Name) (Signature Over Printed Name)
Remarks:
Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody duly verified by the adviser and school head, in cases signature of parents are unavailable.
FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)
