June 25, 2021

This is to authorize ELIZABETH SETON SCHOOL to use the photo of my

child for the scheduled Virtual Recognition Ceremony in accordance with the
Data Privacy Act of 2012.

I understand that the ceremony will be broadcasted through the school’s

official social media platform.

I understand that after the initial broadcast, it will be uploaded at

www.ess.edu.ph.

I understand that I must duly accomplish this form and send it to

dimalanta.candy@ess.edu.ph in PDF format on or before July 16, 2021 for my
child to be included in the preparations.

Name of Learner:
Teodor Rafael C. Torrijos

Grade and Section:

Grade 1 Capiz
Name of Parent/Guardian:
Jenny Lynd C. Torrijos
Signature of Parent/Guardian:

Date signed: July 21, 2021