Republic of the Philippines

DEPARTMENT OF EDUCATION
CORDILLERA ADMINISTRATIVE REGION
SCHOOLS DIVISION OF BENGUET
DISTRICT OF KAPANGAN
BOKLAOAN ELEMENTARY SCHOOL
Boklaoan, Kapangan, Benguet

PARENT CONSENT AND WAIVER

I, ____________________________, as the parent or legal guardian of

_________________ hereby acknowledge that I have been informed of
the details of the conduct of Implementation of Limited Face to Face learning
modality.

I understand that BOKLAOAN ELEMENTARY SCHOOL shall implement the

minimum public health standards set by the government to minimize risk of
the spread of COVID 19, but if cannot guarantee that my child will not
become infected with COVID 19 given that COVID 19 is highly contagious.

I acknowledge that my child/ren’s in persons attendance in school will include

associating with teachers, fellow learners and school personnel, and other
persons inside and outside that may put my child at risk of COVID 19
transmission, notwithstanding the precautions undertaken by the school.

I acknowledge that my child/ren’s participation in this activity is completely

voluntary. While there remains the risk of possible COVID 19 transmissions to
my child/dren, and to the members of my household, I freely assume the said
risk and I permit my child/dren to attend the school under this activity, the
Face-to-Face Classes.

I am aware of the symptoms of COVID 19 include but not limited to, fever or
chills, cough, shortness of breath or difficulty of breathing, body and head
ache, loss of taste and smell, sore throat, congestion, nausea, vomiting and
diarrhea.

I confirm that my child/dren currently has none of those symptoms, and is in

good health. I will not allow my child/dren to physically go to school to attend
classes if my child/dren or any members of my household develops any said
symptoms or any other illness that may or may not related to COVID 19. I will
also inform the school and not allow my child/dren to attend Face to Face
classes if my child/dren or any of my household members tests positive for
COVID 19. My child/dren and I, with my household members, will follow the
required health and safety protocols and procedures adopted by the school and
our community.
To the extend allowed by law and rules, I hereby agree to waive, release and
discharge any and all claims, causes of action, damages and rights against the
school and its personnel as well as officials and personnel of the Department of
Education relative to the conduct of the
activity.
 Republic of the Philippines
DEPARTMENT OF EDUCATION
CORDILLERA ADMINISTRATIVE REGION
SCHOOLS DIVISION OF BENGUET
DISTRICT OF KAPANGAN
BOKLAOAN ELEMENTARY SCHOOL
Boklaoan, Kapangan, Benguet

DATE: ________________

The School Head/Class Adviser

Boklaoan Elementary School
Boklaoan, Kapangan, Benguet

Dear Sir/Madam,

We are the parents of the following pupils who are enrolled in Grade 1 in this
school for the school year 2021-2022. We understand the school will reopened
for conducting the classes in-person/face to face classes. We hereby consent to
the presence of our son/daughter in-person at the school to attend his/her
classes.

We understand the health risk involved. We know that it is not easy to manage
so many pupils and maintain social distancing measure. Yet we hope that the
school will take necessary measures to ensure social distancing guidelines as
far as possible.

We appreciate the efforts of the school staff to impart education during this
pandemic. We wish them all the best.

Sincerely yours,

Name Name of Child/ren Signature