Republic of the Philippines

Department of Education
Division of Camiguin
SIXTO A. ABAO NATIONAL HIGH SCHOOL
Hubangon, Mahinog, Camiguin

Parental Consent and Waiver Form

I confirm that I ____________________________________ am the parent/legal guardian

(Parent/Guardian’s Name)
of___________________________________________.
(Name of Learner)

I hereby confirm my consent to the above learner participating in the

_________________________________. I also confirm that I will undertake to abide by the
obligations which it imposes on me as the parent/legal guardian of the above-named learner.To
the extent allowed by law and rules, I hereby agree to waive, release, and discharge any and all
claims, causes of action, damages, and rights against the school and its personnel as well as
officials and personnel of the Department of Education relative to the conduct of the activity.

Parent/Guardian’s Name(please print)_________________________________________

Signature _____________________________________

Date_________________________________________