Parental Consent in Posting Pictures

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Republic of the Philippines

Department of Education
Region II – Cagayan Valley
Schools Division Office of Cagayan
Buguey South District
PATTAO NATIONAL HIGH SCHOOL- MAIN
CONSENT, WAIVER, INDEMNITY and RELEASE

I, ___________________________________________________ M/F, years of age, hereby


grant permission to the Department of Education (DepEd) and its representatives to
make recordings of my voice and to take photographs and/or videos in which I appear in,
to be used for the communications and various public campaigns of the Agency be it in
print, broadcast, and/or electronic media, at the event and location stated below:

Production name/Project title: ____________________________________________

Location: _________________________________________________________________

I acknowledge that the DepEd owns all rights to these images and recordings. I
further grant the DepEd and its representatives the right to use, display, exhibit,
reproduce, distribute, and create derivative works of these images and recordings in any
media now known or later developed.

I hereby waive any right to inspect or approve the use of the images or recordings
or of any written derivatives. I further waive all moral rights. I also waive any right to
royalties or other compensation arising from or related to the use of the materials.

I hereby release, defend, indemnify, and hold harmless the DepEd and its
representatives from and against any claims, damages, or liability arising from or related
to the use of the images, recordings, or materials, including but not limited to claims of
defamation, invasion of privacy, or rights of publicity or copyright infringement, or any
misuse, distortion, blurring, alteration, optical illusion or use in composite form that may
occur or be produced in taking, processing, reduction or production of the finished
product, its publication or distribution.

I am ___ years of age or older/ I am accompanied by my legal guardian, and I am


competent to enter into this contract/NAME OF GUARDIAN:
________________________________________________ has legal authority to enter into this
contract. I have read this document before signing below, and I fully understand the
contents, meaning and impact of this consent, waiver, indemnity and release.

This consent, waiver, indemnity and release is binding on me, my heirs,


executors, administrators and assigns.

_____________________________________ ______/_______/________
Signature mm dd yyyy

_________________________________________________________ ______/_______/________
Signature over printed name of Parent/Guardian/Teacher mm dd yyyy

Address:_______________________________________________________________________________
Home phone: ______________________________Mobile phone:______________________________
Address: Zone Daisy, Pattao, Buguey, Cagayan 3511
Telephone No.: PLDT (078) 825-0393
300480-Pattao National High School

300480@deped.gov.ph

https://sites.google.com/view/pattaonationalhighschool/home

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