Republic of the Philippines
Department of Education
Cordillera Administrative Region
Schools Division of Baguio City
DISTRICT I
RIZAL ELEMENTARY SCHOOL
RUN FOR A CAUSE
December 3, 2022
Proceeds: For Additional Medical Assistance to a Teacher who is a
Cancer Victim
REGISTRATION
Adult - ₱ 100.00 Student: ₱ 50.00
Name: Age: Sex:
Address:
Civil Status: Cell/Tel#:
Inclusive: coffee, pandesal, number tag
WAIVER
To establish and clarify my purpose in joining this run for a cause, I want to clearly
state that my interest is to help and support the activity to set up good lifestyle through
physical exercise.
In addition, I have come to join and support this run under my own volition and free
will, that nobody will be held liable, accountable and responsible for my untoward incident
beyond control relative to this activity.
In witness hereof, I have hereunder set my own signature this day of
in the City of Baguio, Philippines.
Signature of Parent over Printed Name
____________________________________
Signature of Learner over Printed Name
Address: #1 Gibraltar Road, Baguio City
Telephone No.: (074) 246-1284
E-mail Address: rizalbaguio1937@gmail.com/136404@deped.gov.ph
Facebook Page: DepEdTayo Rizal Elementary School