PARENT CONSENT FORM

This is to certify that I have given consent for my daughter/son

__________ of Grade ____ to participate in the Project EM2ath on
October 19, 2019 to be held in Moncada Auditorium Moncada, Tarlac.

I have considered the benefits she will derive from participating in this activity with the
understanding that every precaution will be taken to ensure her safety. I shall not hold the
school or facilitators responsible for any untoward accident that may happen beyond their
control.

______________________________________________
SIGNATURE OF PARENT OVER PRINTED NAME

_____________________________________________
DATE

CERTIFICATION

We hereby certify that the applicant has met all the requirements for participation in this
event.

________________________________
Adviser

________________________________
School Principal