Republic of the Philippines

Department of Education
SCHOOLS DIVISION OFFICE OF BOGO CITY

_______________________
Date

PARENTAL CONSENT

I/We hereby willing and voluntarily give consent to the participation of my/our son/daughter
____________________________________ in the Learning Camp from ________________________.
(name of learner) (dates of attendance)

I have considered the benefits that my son/daughter will get with 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. DepEd employees and personnel may not be held responsible for any untoward incident
that may happen beyond their control.

______________________________ ______________________________
Signature of Father over Signature of Mother over
Printed Name and Date Printed Name and Date

__________________________________
Signature of Guardian over
Printed Name/Date

___________________________________
Relationship with the Learner

Verified By:

_____________________________________ Date: _________________________

Teacher

Note: If No Parent/s, submit Affidavit of Guardianship duly verified by the teacher. If parents are abroad,
a Special Power of Attorney (SPA) is rendered.