2020 Parents Consent Revised 2

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Revised as of September 26, 2019

Republic of the Philippines


DEPARTMENT OF EDUCATION
XI
(Region)
DAVAO ORIENTAL
(Division)
SERGIO MAWALIC ELEM. SCHOOL
(School)
MAGSAYSAY, LUPON, DAVAO ORIENTAL
(School Address)

____________________
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of


my/our son/daughter __________________________ in the Division
Mathematics Fair 2024 Contest held at Banaybanay Central Elementary
School on November 05, 2024.

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.

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

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)

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