PARENTs CONSENT

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Department of Education

Region III
Division of Pampanga
TELACSAN NATIONAL HIGH SCHOOL
Macabebe

Name of Student: _________________________________________________________________________

Date of Birth: ______________________________________ Sex: ______________________________

Parent’s / Guardian’s Name: _______________________________________________________________

Relationship to Student: ____________________________ Contact Number/s: _____________________

Home Address: ___________________________________________________________________________

Title of the Activity: OKKK! Tambayan (Online Kahusayan para sa Karapatan ng KabataanTambayan!”

As the parent/guardian of the abovementioned learner, I hereby acknowledge that I have been informed

of the details of the off-campus activity and voluntarily and freely elect to participate in this off-campus

activity. Furthermore, I understand the risks associated with an off-campus activity and agree that the rules and

regulations established for the said activity are for the safety and security of the participants, and thus agree to

instruct my child or children to obey them.

Having understood all the aforementioned, I hereby consent to allow my child or children to participate,

acknowledging all of the foregoing. I am also solely responsible for providing travel insurance and any

expenses for my child or children’s participation in the activity.

_________________________________________ ______________________________

Parent/Guardian’s Name and Signature Date


Department of Education
Region III
Division of Pampanga
TELACSAN NATIONAL HIGH SCHOOL
Macabebe

Name of Student: _________________________________________________________________________

Date of Birth: ______________________________________ Sex: ______________________________

Parent’s / Guardian’s Name: _______________________________________________________________

Relationship to Student: ____________________________ Contact Number/s: _____________________

Home Address: ___________________________________________________________________________

Title of the Activity: Purpose Driven Leadership Training

Venue: Tarik Suliman High School, Masantol, Pampanga Date of Activity: October 24&25, 2019

As the parent/guardian of the abovementioned learner, I hereby acknowledge that I have been informed

of the details of the off-campus activity and voluntarily and freely elect to participate in this off-campus

activity. Furthermore, I understand the risks associated with an off-campus activity and agree that the rules and

regulations established for the said activity are for the safety and security of the participants, and thus agree to

instruct my child or children to obey them.

Having understood all the aforementioned, I hereby consent to allow my child or children to participate,

acknowledging all of the foregoing. I am also solely responsible for providing travel insurance and any

expenses for my child or children’s participation in the activity.

_________________________________________ ______________________________

Parent/Guardian’s Name and Signature Date

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