Republic of the Philippines

Department of Education
REGION IX- ZAMBOANGA PENINSULA
SCHOOLS DIVISION OF ZAMBOANGA DEL NORTE
GUTALAC I DISTRICT
SAN ISIDRO ELEMENTARY SCHOOL

PARENTAL CONSENT

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

son/daughter __________________________________________ in the Cluster Meet to be
held at Tampilisan Central School, Tampilisan Zamboanga del Norte on January
10-12, 2023.
I have considered the benefits that my son/daughter will derive from his/her
participation in this activity with the understanding that due care and precaution
will be observed to ensure the comfort and safety of the delegation and that DepEd
employees and personnel may not be held responsible for any untoward incident
that may happen beyond their control.

________________________________ ______________________________
Signature of Father Signature of Mother

________________________________ ______________________________
Name of Father Name of Mother

___________________________________
Signature of Guardian over Printed Name

___________________________________
Relationship with Athlete

Verified by:

______________________________ JULIE ANN P. DUHAYLUNGSOD

Teacher – Adviser Teacher-In-Charge, T- III

Address: San Isidro, Gutalac, ZN Tel. No.: 09516522144

Email: 195507@deped.gov.ph
FB: DepEd Tayo- San Isidro ES 195507