Parental Consent: Department of Education

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Republic of the Philippines

DEPARTMENT OF EDUCATION
X
(Region)
Tangub City
(Division)
Gov. Alfonso D. Tan College
(School)
Maloro , Tangub City
(School Address)

11/22/2018
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 APPLE KITT P. CINCO 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

GILBERT S. CINCO RAQUEL P. CINCO


Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :
ZARLENE M. TIGOL CHONA BEBINA C. PETALIO
______________________________ __________________________
Teacher-Adviser School Head/Registrar

Remarks:

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