NESTLÉ WELLNESS CAMPUS INTER-SCHOOL, INTER-REGION COMPETITION

REGISTRATION FORM and WAIVER

Region: __VI____
Division: _ILOILO_____

SCHOOL INFORMATION:
Name of School: __PANDAC ELEMENTARY SCHOOL________
Category: Grade School ________ Junior High School __________
School Address: _BRGY. PANDAC, PAVIA, ILOILO____

By submitting this registration form we hereby:

1. Confirm our participation in the following competitions for the SY 2022–2023 Nestlé Wellness Campus Program: (Please check
the box below for the contest in which your school will participate).

Recycled Artwork Contest (Grade School Only) - (Signed Parents Waiver Form Needed)

Virtual Poster Making Contest (High School Only) - (Signed Parents Waiver Form Needed)

Virtual Cook-Off Competition - (Signed Parents Waiver Form Needed)

Virtual Dancercise Competition - (Signed Parents Waiver Form Needed)

Healthy Habits Best Practices Competition

Note: Students participating in the contest should fill out the Parents' Waiver Form. The duly signed parental waiver form is
attached to the registration form. Please note further, that there is a separate parental waiver per contest.

2. Understand the full mechanics and abide by the rules and regulation of the contest.

3. Agree to represent our Division in the Nestlé Wellness Campus Inter-school, Inter- region Competition.
Certify that we have started the implementation of the Nestlé Wellness Campus program prerequisite to the contest.

Kindly note the date when you have started with the program implementation of the following activities: ∙

● Wellness Campus Modules

Start Date: ___September 5, 2022___

● Wellness Campus Dancercise

Start Date: __September 23, 2022______

______ROWENA S. FACERONDA______
School Representative’s Signature Over Printed Name

_________09613188621__________
Contact Number

Date: ___October 28, 2022___