Lo

Republic of the Philippines

Department of Education

ONLINE DISTANCE LEARNING ACTIVITES CONSENT FORM

NAME OF STUDENT
Lorin Angela C. Velasco

GRADE LEVEL
12

NAME OF PARENT / Rusielle Antonnette C. Velasco

GUARDIAN

I hereby give my consent to VALENZUELA CITY SCHOOL OF MATHEMATICS AND

SCIENCE and the designated teachers of my child/ward to:

1. Conduct online interaction through the CANVAS learning management system and
whatever social media platforms with my child / ward for any distance learning
activities;
2. To keep a record of online interaction with my child / ward, whenever recording is
made;
3. To take snapshots/images/videos which may include my child’s/ward’s image for
documentation and other lawful purposes;
4. To post in the official school social media page/web page/private social media
group; the image, name and section of my child/ward as well as any
acknowledgement/awards that he/she is entitled; and
5. Other similar processing of information of my child/ward for any activities
sanctioned by DepEd.

06/09/21 Rusielle Antonnette C. Velasco

Date Signed Signature over Printed Name

Ref: Annex A of Regional Memorandum NCR – NO. 238, s. 2020 re: Safeguarding Standards during Online Interaction with Learners