24th PHILIPPINE MATHEMATICAL OLYMPIAD

A project of the Mathematical Society of the Philippines

and the Department of Science and Technology – Science Education Institute

pmo.ph

pmo@math.upd.edu.ph

facebook.com/PhilippineMathematicalOlympiad
DATA PRIVACY AND twitter.com/PhilMathOlym

CONSENT FORM FOR

CONTESTANTS – MINORS
(Version 1, Jan. 13, 2022)

INSTRUCTIONS:
1. This form should be accomplished for each contestant who is a minor on the scheduled day (February 19, 2022) of the
Qualifying Stage, i.e., the contestant will only turn 18 years old on or after February 20, 2022.
2. You can print this form, fill out and sign, then scan. However, if you are comfortable with fillable pdf files, you can fill it
out in your computer. Do not forget to include the signature.
3. Contestants should submit this signed form to the School Coordinator via email.
4. The School Coordinator should collect all forms and submit them to his/her respective Regional Coordinator via email.
See pmo.ph.
5. Contestants and School Coordinators SHOULD NOT SEND THIS DIRECTLY TO THE PMO EMAIL ADDRESS.

I hereby declare that I am the parent or legal guardian of the contestant who is a minor under my responsibility,
hereinafter referred to as the Contestant, and that I have the legal authority to sign this authorization in his/her name.

By affixing my signature below, I confirm that I have read and understood this Declaration and Consent Form and
hereby permit the Contestant to participate in the 24th Philippine Mathematical Olympiad (PMO), hereinafter referred
to as the Contest. Furthermore, I and the Contestant agree to be bound by the General Guidelines of the Contest and by
this Declaration and Consent Form.

I understand and agree that participation is voluntary and that the Mathematical Society of the Philippines (MSP) and
the organizers of the 24th PMO, hereinafter referred to as the Organizers, will be collecting personal information about
the Contestant in order to administer this Contest. This information will be handled in accordance with Republic Act
10173 or the Data Privacy Act of 2012.

I hereby authorize the MSP and the Organizers to collect, use and disclose the personal information of the Contestant
for purposes of administering the Contest, including determining eligibility, promoting the Contest, making public
announcements of the winners of various awards of the Contest, and other communication activities.

I also understand that in order for the Contestant to participate in this Contest, his/her picture must be submitted. I also
hereby authorize the MSP and the Organizers to use and publish or display all images, videos, or voice recordings of
the Contestant, in whole or in part, with or without modification, individually or in combination with other images or
videos, on the websites and official social media accounts of the MSP and of the PMO, for promotional presentations,
communications activities, and media purposes.

ROSELYN B. PANGANOD
Printed Name of the Parent or Guardian Signature of the Parent or Guardian

IVY ROSE B. PANGANOD February 09, 2022

Printed Name of the Contestant Date

Mathematical Society of the Philippines  http://www.mathsociety.ph

Institute of Mathematics, University of the Philippines, Diliman, Quezon City, 1101 Philippines