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Republic of the Philippines

DEPARTMENT OF EDUCATION
______VI- Western Visayas_______
(Region)
_______Negros Occidental______
(Division)
_C.L. Hodges Elementary School_
(School)
Brgy. Alim, Hinoba-an, Negros Occidental
(School Address)

December 5, 2023
Date

PARENTAL CONSENT

I/We hereby willingly and voluntarily give consent to the participation of


my daughter ________________________________ in the Simultaneous
Tree-planting Activity by all DepEd public schools nationwide on
December 6, 2023 at Prk. 3, Brgy. Alim, Hinoba-an, Negros Occidental at
exactly 7:30 in the morning. This activity of the Department of Education is in
line with the DepEd’s 236,000 Trees- A Christmas Gift for the Children under
DepEd Memorandum OUOPS No. 2023-01-11025.

I/We have considered the benefits that my daughter will derive from
his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure her health and safety and
that DepEd employees and personnel may not be responsible for any
untoward incident that may happen beyond their control.

Signature of Guardian Over Printed Name Signature of Mother/ Father Over Printed Name

Verified:

SHEILA R. RELIQUIAS
Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

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