Republic of the Philippines

Department of Education
Region I
SCHOOLS DIVISION OFFICE I PANGASINAN
MANGATAREM NATIONAL HIGH SCHOOL
Mangatarem, Pangasinan

PARENTAL CONSENT

I, __________________________________________(print Parent/Guardian’s

full name) permit my son/daughter, ___________________________________(print

Student’s full name) of Grade 12 HUMSS - CARTWRIGHT (Strand & Section), to

participate in the COMMUNITY SERVICE as part of their requirements in Community

Engagement, Solidarity, and Citizenship subject which they are enrolled in the 2 nd semester

2023-2024.

I am fully aware that the School/ School Administration and/or Subject

Teacher will not be held liable of any untoward incident that may happen to my child that is

beyond their control.

_______________________________
Signature of Parent over Printed Name

Very truly yours,

VIVIAN D. RESULTAY
SHS Teacher

Noted: Approved:

CRISTOPHER REYMOND S. CASTILLO, PhD ELVIRA C. VIRAY, EdD

OIC-Senior High School School Principal IV