Republic of the Philippines

Department of Education
Region V
SCHOOLS DIVISION OF ALBAY
Lignon Hill, Bogtong, Legazpi City

Enclosure No. 3 to Division Memorandum 71 s. 2019

ELECTION OF DIVISION FEDERATED SPG AND SSG OFFICERS SY 2019-2020

Waiver/ Parental Consent Form

I, hereby willingly and voluntary consent to the participation of my son/daughter,

Mr./Miss ____________________________________ who is a Grade _________ in
_______________________________________, Albay in the Division Federated Supreme Pupil
Government and Supreme Student Government Election to be held at Mi Corazon Convention
Center, Salugan, Camalig, Albay on July 19, 2019, 8:00-5:00 pm.

As the elected SPG/SSG President of his/her school, I have considered the benefits that
he/she will derive from him/her participation in this activity with the understanding that I will
not hold any party responsible for any untoward accident and/or incident which may happen to
my son/daughter during the above mentioned activity as long as due care and precautions are
observed to ensure the safety of the participants.

I hereby affix my signature this _______ day of ______________at

_______________________.

__________________________________________________
Parent’s/Guardian’s Signature over Printed Name

____________________________________________________
Parent’s/Guardian’s Contact Number
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