Republic of the Philippines

Department of Education
Cordillera Administrative Region
Schools Division of Kalinga
RIZAL NATIONAL SCHOOL OF ARTS AND TRADES
Liwan West, Rizal, Kalinga

P A R E N TA L CONSENT

I/We hereby willingly and voluntarily give consent to the participation of my/our
son/daughter_____________________________________________________, a learner of
Rizal National School of Arts and Trades, to attend the Senior High School Work
Immersion Program at __
on Apr(excluding Saturdays and Sundays).
I/We hereby acknowledge that sufficient information has been provided by the
school with respect to the activity, duration, location, method of transportation, participants
and supervision.
I/We hereby acknowledge that certain RISKS OF INJURY are inherent to participate
in learning activities outside the school. These types of injuries may be minor or serious and
may result from one’s actions, or the actions or inaction of others, or a combination of both.
I/We understand that the Rules and Regulations established for the activity are
designed for the safety and protection of the participants and hereby undertake to inform
my child to abide by these rules and regulations.
I/We have considered the benefits that my/our child will derive from 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 and that DepEd employees and
personnel may not be held responsible for any untoward incident that may happen beyond
their control.

_______________________________ _______________________________
Name & Signature of Father Name & Signature of Mother

_______________________________
Name & Signature of Guardian

Verified by: ______________________________________________

Adviser

Address: Liwan West, Rizal, Kalinga

Email Address: 305217@deped.gov.ph