Annex 1

Learning Camp Registration Template

Republic of the Philippines

DEPARTMENT OF EDUCATION
REGION X –NORTHERN MINDANAO
SCHOOLS DIVISION OF MISAMIS ORIENTAL
SANTA ANA ELEMENTARY SCHOOL
Santa Ana, Tagoloan, Misamis, Oriental

Learning Camp Registration Template

Camp Group: _________________________________________________________

Name: _________________________________________________________

If in Senior High School, specify the strand: _______________________________________

Age: _________________________________________________________

Address: _________________________________________________________

Parent/legal Guardian: ________________________________________________________

Contact Number: _________________________________________________________

Final Grade in English: _____________________

Math: _____________________

Science: _____________________
Annex 2
Parent’s Consent Template

Republic of the Philippines

DEPARTMENT OF EDUCATION
REGION X –NORTHERN MINDANAO
SCHOOLS DIVISION OF MISAMIS ORIENTAL
SANTA ANA ELEMENTARY SCHOOL
Santa Ana, Tagoloan, Misamis, Oriental

Learning Camp Registration Template

___________________________
Date
PARENT/LEGAL GUARDIAN CONSENT

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter ______________________________________________ to the Learning Camp
from _____________________________.
I have considered the benefits that my son/daughter will get from his/her participation
in this activity provided 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 and 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, to submit Power of Attorney (SOA) if needed.