Revised as of February 2024 Republic of the Philippines

DEPARTMENT OF EDUCATION
Region VII
(Region)

Mandaue City Division

(Division)

School
(School)

Mandaue City
(School Address)

CERTIFICATE OF COMMITMENT
(CHAPERONE)
__________________
(Date) xxxxxxx

I, ________________________________________,
xxxxxxx of legal age, single / married / widow, Filipino citizen, and presently working as

xxxxxxx
________________________ at _________________________, hereby commit myself to nurture the athletes of _________________________, provided that

xxxxxxx
due care and precaution will be observed to ensure the comfort and safety of the athletes until the last day on the Lower Meet up to the Palarong Pambansa.

xxxxxxx
That I will not interfere in the Coaching of our Team or Act as Coach of the Athlete as it is not my responsibility to do so.

__________________________________
xxxxxxx
Signature over Printed Name of Chaperone

Verified:

__________________________________
xxxxxxx
Signature over Printed Name of School Head

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)