PANGAPISAN INTEGRATED SCHOOL

______________
DATE

I/We hereby willingly and voluntarily give consent to the participation of my son/daughter
____________________________________to attend the INTRAMURAL 2022 (November 19, 2022) at
Pangapisan Integrated School, Pangapisan, Alaminos City, Pangasinan

I have considered the benefits that my son/daughter will derive from his/her participation in this activity
provided that due care and precaution will be observed to ensure the comfort and safety of my
son/daughter and that DepEd employees and personnel may not be held responsible for any untoward
incident that may happen beyond their control.

____________________________________
PARENT’S SIGNATURE OVER PRINTED NAME

Prepared by:

MICHAEL B. BALTAZAR / DARREN B. ASTRO

MAPEH Coordinator

Noted by:

LORNALYN M. CERILO
Head Teacher

PANGAPISAN INTEGRATED SCHOOL

____________________
DATE

I/We hereby willingly and voluntarily give consent to the participation of my son/daughter
____________________________________to attend on INTRAMURALS 2022 (November 19, 2022) at
Pangapisan Integrated School, Pangapisan, Alaminos City, Pangasinan

I have considered the benefits that my son/daughter will derive from his/her participation in this activity
provided that due care and precaution will be observed to ensure the comfort and safety of my
son/daughter and that DepEd employees and personnel may not be held responsible for any untoward
incident that may happen beyond their control.

____________________________________
PARENT’S SIGNATURE OVER PRINTED NAME

Prepared by:

MICHAEL B. BALTAZAR / DARREN B. ASTRO

MAPEH Coordinator

Noted by:

LORNALYN M. CERILO
Head Teacher