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Student Participation Clearance Form

I hereby give consent for my child (print name), , to participate in the Career Guidance
Activity on Monday, May 24, 2021.

I agree to abide by the COVID -19 rules and guidance for the activity outlined in the school’s, Tagoloan District’s and DepEd’s health protocols as recommended
by the IATF.

I hereby authorize and give permission for teachers and administrators to ask general questions related to COVID-19 symptoms and take appropriate actions in
reporting any concerns if necessary, prior to participation in this activity. This authorization includes, but is not limited to, any treatment deemed necessary by
certified personnel, physicians, hospital emergency room physicians and hospitals.

I hereby release the Tagoloan Senior High School and all school personnel for any and all liability associated with such necessary treatment related to physical
injury and/or illnesses during the said activity.

In addition, I assume any expenses for liability for any COVID-19 symptoms and/or injury received by the above-named student while participating in the Career
Guidance Program.

I accept full responsibility for medical and hospital expenses and any other related expenses and do hereby hold harmless the Tagoloan School District and the
Tagoloan Senior High School, their agents or assignees, of responsibility for any such injury or illness and waive any and all claims which may-arise against
them.

My signature below indicates that I agree to this plan/activity, that I have reviewed it and that I give permission for my child to participate.

Parent/Legal Guardian Parent/Legal Guardian

Print Name Signature

Contact Number Date

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Student Participation Clearance Form

I hereby give consent for my child (print name), , to participate in the Career Guidance
Activity on Monday, May 24, 2021.

I agree to abide by the COVID -19 rules and guidance for the activity outlined in the school’s, Tagoloan District’s and DepEd’s health protocols as recommended
by the IATF.

I hereby authorize and give permission for teachers and administrators to ask general questions related to COVID-19 symptoms and take appropriate actions in
reporting any concerns if necessary, prior to participation in this activity. This authorization includes, but is not limited to, any treatment deemed necessary by
certified personnel, physicians, hospital emergency room physicians and hospitals.

I hereby release the Tagoloan Senior High School and all school personnel for any and all liability associated with such necessary treatment related to physical
injury and/or illnesses during the said activity.

In addition, I assume any expenses for liability for any COVID-19 symptoms and/or injury received by the above-named student while participating in the Career
Guidance Program.

I accept full responsibility for medical and hospital expenses and any other related expenses and do hereby hold harmless the Tagoloan School District and the
Tagoloan Senior High School, their agents or assignees, of responsibility for any such injury or illness and waive any and all claims which may-arise against
them.

My signature below indicates that I agree to this plan/activity, that I have reviewed it and that I give permission for my child to participate.

Parent/Legal Guardian Parent/Legal Guardian

Print Name Signature

Contact Number Date