Republic of the Philippines

Department of Education
Region XII
Division of Sarangani
ALEGRIA NATIONAL HIGH SCHOOL
Alegria, Alabel, Sarangani Province

Parental Consent Form

Student’s Name___________________________________ Age________ Birth Date ______________

Address____________________________________________________ Phone ________________
Grade Level & Section ___________________________________

Parents’/Guardians’ Names ___________________________________________________________

Phone number _________________________

To Whom It May Concern:

The undersigned does hereby give permission for our (my) child, _____________________________,
(Name of Child)
to attend and participate in the drum and lyre team of Alegria National High School in preparation for
the coming competition this September which is in lined with the Kasadyaan Festival 2019.

We (I) permit our (my) child to join the practices 4 PM to 7 PM on weekdays and 8 AM to 4 PM during
weekends. Any changes to this schedule especially when the competition day is near are flexible to
us provided that the students are informed ahead of time. Start of practice will be on July 29, 2019.

The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection
with the trainer’s fee, uniform and props to be used for the said competition.

We (I) do hereby release, forever discharge and agree to hold harmless the school, the teachers in
charge of the team, the principal and the trainers thereof from any and all liability, claims or demands
for personal injury, sickness, or death, as well as property damage and expenses, of any nature
whatsoever which may be incurred by the undersigned and the student-participant that occur while
said student-participant is participating in the above described activity.

Furthermore, we (I) (and on behalf of our (my) child-participant), hereby assume all risk of personal
injury, sickness, death, damage, and expense as a result of participation in the activity joined by my
son/ daughter.

The undersigned further hereby agree(s) to hold harmless and assure said school, its principal,
teachers, and trainers on any liability sustained by the school as a result of the negligent, willful, or
intentional acts of the said participant, including the expenses generated for this activity.

_______________________________________ ________________________________________________
Student- Participant’s Name & Signature Parent/ Guardian’s Name & Signature

Emergency Contacts:
Name: ____________________________________ Relationship: ___________________ Phone: _________________
Name: ____________________________________ Relationship: ___________________ Phone: _________________

REMARKS:
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_______________________________________________________________________________________.