PARENT’S/GUARDIAN’S CONSENT FORM

Name of the Learner: _____________________________________________________________

Date of Birthday: ___________________________ Sex: _______________________________
Parent’s/Guardian’s Name: _______________________________________________________
Relationship to Learners: _________________________________________________________
Home Address: ____________________________________________________________________
____________________________________________________________________________________
Contact Numbers: _________________________________________________________________
Title of the Activity: DURUNGAWAN: Pagbabalik-Tanaw sa mga Musika ng Kahapon
& MURAL Exhibit
Venue (Pre & Post): Sta. Elena High School Date: February 1-27, 2023
Venue (General Rehearsal): Roman Garden Date: February 24, 2023
Venue (Actual Day): Roman Garden Date: February 25, 2023,
7am until 11pm

As the parent/ guardian of the abovementioned learner, I hereby acknowledge

that I have been informed of the details of the off-campus activity and voluntarily and
freely elect to participate in this off-campus activity. Furthermore, I understand the
risks associated with an off-campus activity and agree that the rules and regulations
established for the said activity are for the safety and security of the participants, and
thus agree to instruct my child or children to obey them.

Having understood all the aforementioned, I hereby consent to allow my child or

children to participate, acknowledging all of the foregoing. I am also solely responsible
for providing travel insurance and any expenses for my child or children's participation
in the activity.

___________________________________ _______________________
Parent/Guardian’s Name and Date
Signature

Notes for parents and guardians: (other information you may wish to inform the teacher,
such as child’s medical condition, etc.)
 OPTIONAL
(If you know someone that can help us provide financial assistance to the project, kindly
provide their contact details below so that the names could be sent to the school PTA)

1. LIST OF NAMES FOR SPONSORSHIP

Name: _____________________________________________________
Designation & Company/Business: ________________________________________________
_____________________________________________________________________________________
Contact Number (email, cp number, telephone no.) : __________________________________

2. LIST OF NAMES FOR SPONSORSHIP

Name: _____________________________________________________
Designation & Company/Business: ________________________________________________
_____________________________________________________________________________________
Contact Number (email, cp number, telephone no.) : __________________________________

3. LIST OF NAMES FOR SPONSORSHIP

Name: _____________________________________________________
Designation & Company/Business: ________________________________________________
_____________________________________________________________________________________
Contact Number (email, cp number, telephone no.) : __________________________________

4. LIST OF NAMES FOR SPONSORSHIP

Name: _____________________________________________________
Designation & Company/Business: ________________________________________________
_____________________________________________________________________________________
Contact Number (email, cp number, telephone no.) : __________________________________

5. LIST OF NAMES FOR SPONSORSHIP

Name: _____________________________________________________
Designation & Company/Business: ________________________________________________
_____________________________________________________________________________________
Contact Number (email, cp number, telephone no.) : __________________________________