Revised as of September 26, 2019

Republic of the Philippines

DEPARTMENT OF EDUCATION
IV-A CALABARZON
(Region)
Laguna
(Division)
Dayap Elementary School
(School)
Ilaya St. Brgy. Dayap Calauan Laguna
(School Address)

January 15, 2024

Date

PARENTAL CONSENT

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

my/our son/daughter CLARK KENT N. PUMA in BADMINTON
EVENT in all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

ROMMEL M. PUMA MA REINA CRISTINA N. PUMA

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

MYDEN U. ESLLERA CORAZON M. NAVAREZ

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
IV-A CALABARZON
(Region)
Laguna
(Division)
Dayap Elementary School
(School)
Ilaya St. Brgy. Dayap Calauan Laguna
(School Address)

January 15, 2024

Date

PARENTAL CONSENT

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

my/our son/daughter IAN GIANNE C. AGUILING in BADMINTON
EVENT in all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

ROBERTO L. AGUILING BRIGIDA C. DE LEON

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

NONA S. ISON CORAZON M. NAVAREZ

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
IV-A CALABARZON
(Region)
Laguna
(Division)
Dayap Elementary School
(School)
Ilaya St. Brgy. Dayap Calauan Laguna
(School Address)

January 15, 2024

Date

PARENTAL CONSENT

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

my/our son/daughter JAIRAH CLAIRE C. SEFIL in BADMINTON
EVENT in all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

PERCIBAL S. SEFIL LODELIN C. SEFIL

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

MYDEN U. ESLLERA CORAZON M. NAVAREZ

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
IV-A CALABARZON
(Region)
Laguna
(Division)
Dayap Elementary School
(School)
Ilaya St. Brgy. Dayap Calauan Laguna
(School Address)

January 15, 2024

Date

PARENTAL CONSENT

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

my/our son/daughter KIARA SHANE B. LAJARCA in BADMINTON
EVENT in all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

EDBRYAN P. LAJARCA CRISTABELLE S. BRIONES

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

JONATHAN S. PAROAN CORAZON M. NAVAREZ

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

 Republic of the Philippines
DEPARTMENT OF EDUCATION
IV-A CALABARZON
(Region)
Laguna
(Division)
Dayap Elementary School
(School)
Ilaya St. Brgy. Dayap Calauan Laguna
(School Address)

January 15, 2024

Date

PARENTAL CONSENT

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

my/our son/daughter SHERRY MAE E. SARMIENTO in BADMINTON
EVENT in all School Sports Meets up to the Palarong Pambansa.

I/We have considered the benefits that my son or daughter will derive
from his/her participation in this activity provided that due care, diligence and
necessary precautions will be observed to ensure his/her health and safety.

Further, I/We authorize the personnel of Department of Education to

collect, process, retain, and dispose of personal information of the above-
mentioned athlete in accordance with the Data Privacy Act of 2012.

BOBBY Z. SARMIENTO MARIE RHOSE E. SARMIENTO (Deceased)

Signature of Father Over Printed Name Signature of Mother Over Printed Name

Verified:

ANNA CRIZELDA L. GALISTE CORAZON M. NAVAREZ

Adviser School Head/Registrar
(Signature Over Printed Name) (Signature Over Printed Name)

Remarks:

Note:
Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care and Custody
duly verified by the adviser and school head, in cases signature of parents are unavailable.

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)