Republic of the Philippines

Department of Education
CARAGA
(Region)
SURIGAO DEL SUR
(Division)
TAMBIS NATIONAL HIGH SCHOOL

Tambis, Barobo, Surigao del Sur

(School Address)

______________
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 __________________________________in the District, 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

Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

GLORIA M. PARAGUYA
Teacher-Adviser/School Head/Registrar

Republic of the Philippines

 Department of Education
CARAGA
(Region)
SURIGAO DEL SUR
(Division)
TAMBIS NATIONAL HIGH SCHOOL

Tambis, Barobo, Surigao del Sur

(School Address)

______11-26-13______
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 ______JUDY P. QUIBAN_____________ 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

NATHANIEL QUIBAN SR. ADELINA P. QUIBAN (decease)

Name of Father Name of Mother

Signature of Guardian over Printed name

DAUGHTER
(Relationship with the Athlete)

Verified by :

IRENIA R. DELOS SANTOS

Teacher-Adviser/School Head/Registrar

Republic of the Philippines

 Department of Education
CARAGA
(Region)
SURIGAO DEL SUR
(Division)
TAMBIS NATIONAL HIGH SCHOOL

Tambis, Barobo, Surigao del Sur

(School Address)

______11-26-13______
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 ______LEAH B. VERTUDAZO_____________ 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

ESTELITO B. VERTUDAZO PRECIOSA B. VERTUDAZO

Name of Father Name of Mother

Signature of Guardian over Printed name

DAUGHTER
(Relationship with the Athlete)

Verified by :

IRENIA R. DELOS SANTOS

Teacher-Adviser/School Head/Registrar

Republic of the Philippines

 Department of Education
CARAGA
(Region)
SURIGAO DEL SUR
(Division)
TAMBIS NATIONAL HIGH SCHOOL

Tambis, Barobo, Surigao del Sur

(School Address)

______11-26-13______
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 ______BEVELYN C. OPRIASA_____________ 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

BIENVENIDO O. OPRIASA EVELYN C. OPRIASA

Name of Father Name of Mother

Signature of Guardian over Printed name

DAUGHTER
(Relationship with the Athlete)

Verified by :

IRENIA R. DELOS SANTOS

Teacher-Adviser/School Head/Registrar

Republic of the Philippines

Department of Education
 CARAGA
(Region)
SURIGAO DEL SUR
(Division)
TAMBIS NATIONAL HIGH SCHOOL

Tambis, Barobo, Surigao del Sur

(School Address)

______11-26-13______
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 ______JASTINE M. SINDO_______ 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

ARACELI T. SINDO
Name of Father Name of Mother

Signature of Guardian over Printed name

DAUGHTER
(Relationship with the Athlete)

Verified by :

IRENIA R. DELOS SANTOS

Teacher-Adviser/School Head/Registrar

Republic of the Philippines

Department of Education
CARAGA
 (Region)
SURIGAO DEL SUR
(Division)
TAMBIS NATIONAL HIGH SCHOOL

Tambis, Barobo, Surigao del Sur

(School Address)

______11-26-13______
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 ______ZAIKEN E. DILAG_____________ 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

TONY DILAG ELSIE ENGAYAS

Name of Father Name of Mother

Signature of Guardian over Printed name

DAUGHTER
(Relationship with the Athlete)

Verified by :

IRENIA R. DELOS SANTOS

Teacher-Adviser/School Head/Registrar

Republic of the Philippines

Department of Education
CARAGA
(Region)
 SURIGAO DEL SUR
(Division)
TAMBIS NATIONAL HIGH SCHOOL

Tambis, Barobo, Surigao del Sur

(School Address)

______11-26-13______
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 ______REAH FE A. DAGCUTA_____________ 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

ROLANDO DAGCUTA MARCEDITA DAGCUTA

Name of Father Name of Mother

Signature of Guardian over Printed name

DAUGHTER
(Relationship with the Athlete)

Verified by :

IRENIA R. DELOS SANTOS

Teacher-Adviser/School Head/Registrar

Republic of the Philippines

Department of Education
CARAGA
(Region)
SURIGAO DEL SUR
 (Division)
TAMBIS NATIONAL HIGH SCHOOL

Tambis, Barobo, Surigao del Sur

(School Address)

______11-26-13______
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 ______SHELLA MAE CAPIN_____________ 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.

FE C. CAPIN
Signature of Father Signature of Mother

FE C. CAPIN
Name of Father Name of Mother

Signature of Guardian over Printed name

DAUGHTER
(Relationship with the Athlete)

Verified by :

IRENIA R. DELOS SANTOS

Teacher-Adviser/School Head/Registrar