Republic of the Philippines

Department of Education
REGION IX, ZAMBOANGA PENINSULA
SCHOOLS DIVISION OF ZAMBOANGA CITY
CULIANAN NATIONAL HIGH SCHOOL
Culianan, Zamboanga City

CONSENT
To Parents/Guardians:

Culianan National High School is committed to celebrating and honoring the Class of 2022 during the new
Normal set-up under alert level 1. In recognition of the need for new school traditions to honor the extraordinary
accomplishments of the Class of 2022, a virtual Moving Up ceremony or a possible limited face to face Moving Up
ceremony is being planned. The virtual Moving Up ceremony shall be held using Facebook Live via Private Facebook
Group and will be attended by only the awardees, their parents/guardians, teachers, and school administration.
On the other hand, if the alert level status of our city remains the same, a possible face to face ceremony shall be
conducted.
Hence, we hereby seek for your consent to the activities listed below. Tick the box for which you grant consent
to your child’s participation.

Attend the face-to face pictorial on a scheduled date, ensuring that not all awardees will come to
school on the same schedule to ensure social distancing.

Include images or videos of my child in a compilation for the virtual Moving Up ceremony.

Participate in the virtual Moving Up Ceremony.

Participate in limited face to face Moving Up ceremony.

WAIVER (for virtual Moving Up Ceremony)

I acknowledge that I have read the Facebook Privacy Policy and consent to the use of the platform for virtual
ceremony purposes. I further acknowledge and understand that Facebook is a third-party platform outside of the
control of Culianan National High School. As the parent/guardian, I consent to the use of my child’s name or my child’s
photograph or likeness, voice, or creative work(s) on the internet, CD, electronic/digital media, or print media. I will
not hold the school, its faculty and staff, and the ceremony committee liable and accountable for any untoward
internet-related incident.

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Name of Learner Signature over printed Name of Parent/Signature

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Grade & Section Date