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MAYON NATIONAL HIGH SCHOOL

Mayon, Castilla, Sorsogon

PARENTS/ GUARDIAN CONSENT FORM

NAME OF LEARNER: ____________________________


DATE OF BIRTH: _______________________________ As the Parent/ Guardian of the
PARENTS/ GUARDIAN NAME: ____________________ mentioned learner, I hereby acknowledge that I
RELATIONSHIP TO LEARNER: _____________________ have been informed of the details of the
HOME ADDRESS: ______________________________ activity and voluntarily freely elect to allow the
CONTACT NUMBER: ____________________________ school to use and publish the data and picture
TITLE OF ACTIVITY: VIRTUAL RECOGNITION RITES
DATE OF ACTIVITY: JULY 13, 2021
of my ward, who is a minor, in the social media
platform they will be using to hold the VIRTUAL
RECOGNITION RITES.
_______________________________________
Parents/ Guardian Signature over Printed Name

MAYON NATIONAL HIGH SCHOOL


Mayon, Castilla, Sorsogon

PARENTS/ GUARDIAN CONSENT FORM

NAME OF LEARNER: ____________________________


DATE OF BIRTH: _______________________________ As the Parent/ Guardian of the
PARENTS/ GUARDIAN NAME: ____________________ mentioned learner, I hereby acknowledge that I
RELATIONSHIP TO LEARNER: _____________________ have been informed of the details of the
HOME ADDRESS: ______________________________ activity and voluntarily freely elect to allow the
CONTACT NUMBER: ____________________________ school to use and publish the data and picture
TITLE OF ACTIVITY: VIRTUAL RECOGNITION RITES
DATE OF ACTIVITY: JULY 13, 2021
of my ward, who is a minor, in the social media
platform they will be using to hold the VIRTUAL
RECOGNITION RITES.
_______________________________________
Parents/ Guardian Signature over Printed Name

MAYON NATIONAL HIGH SCHOOL


Mayon, Castilla, Sorsogon

PARENTS/ GUARDIAN CONSENT FORM

NAME OF LEARNER: ____________________________


DATE OF BIRTH: _______________________________ As the Parent/ Guardian of the
PARENTS/ GUARDIAN NAME: ____________________ mentioned learner, I hereby acknowledge that I
RELATIONSHIP TO LEARNER: _____________________ have been informed of the details of the
HOME ADDRESS: ______________________________ activity and voluntarily freely elect to allow the
CONTACT NUMBER: ____________________________ school to use and publish the data and picture
TITLE OF ACTIVITY: VIRTUAL RECOGNITION RITES
DATE OF ACTIVITY: JULY 13, 2021
of my ward, who is a minor, in the social media
platform they will be using to hold the VIRTUAL
RECOGNITION RITES.
_______________________________________
Parents/ Guardian Signature over Printed Name

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