Republic of the Philippines

Department of Education
Region IV-A CALABARZON
City Schools Division of Batangas City
Alangilan Senior High School
Alangilan, Batangas City

CONSENT FORM

I, _____________________________, of legal age, hereby allow my _____________

(Name of Parent/Guardian) (relationship to the child)

____________________________ _____________________ to participate in

(Student Name) (Strand/ Grade/Section)

the Division of Batangas City Schools Press Conference________________________

on December 19 Monday ( online)- 20 Tuesday ( face to face), 2022_______to be held at
Batangas City Dec. 20,2022
(Name of Activity) (Date of Activity)

_______Batangas City_( various venues)________.

(Place of event)

I am fully aware of the protection to abide by the obligations which imposes on me as the
parent/legal guardian of the above-named child.

I confirm that all details are correct and I am able to give parental consent for my child to
participate on the said activity.

Name:(please print)_________________________________________

Signature _____________________________________

Contact Details

Name of Child__________________________________________

Address_______________________________________________

_______________________________________________

Parent’s Mobile Phone No. ________________________________

Address: Primewater Road, Alangilan, Batangas City, Batangas 4200

Telephone No: (043) 741 - 8682
Email: alangilan.shs@deped.gov.ph
“Soar High with Excellence, Lead with Confidence”