Republic of the Philippines

Department of Education
CARAGA Administrative Region
Division of Agusan del Norte
BANGONAY NATIONAL HIGH SCHOOL

June 14. 2023

Ma’am/ Sir:

Blessed Day!
In connection with the Municipal Drum and Lyre Competition held on July 1, 2023 as part of
Habongan 102 Celebration and our school is one of the contestants, the undersigned would like to
ask permission that the following students-contestants be allowed to have a team practice.
Furthermore, it is requested that they be excused from their classes from June 14-15, 2023,
and they be allowed to make up for exams, activities, or assignments that they might miss.
Your favorable response will be highly appreciated.

Truly yours,

RUTHCHEL LACHICA-MORTA
DLC Coordinator

Noted and Approved:

MARIBETH E. ROSALES
Head Teacher

Address: Bangonay, Jabonga, Agusan del Norte

Telephone Number: (085) 803-0127
Email Address: adn.bangonaynhs@deped.gov.ph
Facebook: Bangonay NHS
 Republic of the Philippines
Department of Education
CARAGA Administrative Region
Division of Agusan del Norte
BANGONAY NATIONAL HIGH SCHOOL

NAME OF TEACHER/ADVISER SIGNATURE

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Address: Bangonay, Jabonga, Agusan del Norte

Telephone Number: (085) 803-0127
Email Address: adn.bangonaynhs@deped.gov.ph
Facebook: Bangonay NHS
 Republic of the Philippines
Department of Education
CARAGA Administrative Region
Division of Agusan del Norte
BANGONAY NATIONAL HIGH SCHOOL

PARENT CONSENT AND WAIVER FORM

As a parent/guardian of the student-participant, I hereby give my consent, and acknowledge
by my signature that my son/daughter ___________________________________ of Grade ____
Section_____ will join the Municipal Drum and Lyre Competition to be held at Jabonga, Agusan del
Norte on July 1, 2023.
I am aware of the usual risks and dangers inherent in the said contest thus, accidents can
occur with or without any fault on either part of the student, or the teachers where the contest is
taking place. By allowing my child to participate in this activity, I accept the risk or any untoward
incident, and conform to the school rules and regulations that this activity is suitable for my son or
daughter in order to enhance his/her skills as a student.
I have read and understood the terms of this consent and waiver , and understood well
that is binding upon me, my heirs, executors and administrators.

Date: ____________

_______________________________ ____________________________
Signature of Student-Participant Signature of Parent-Gurdian

PARENT CONSENT AND WAIVER FORM

As a parent/guardian of the student-participant, I hereby give my consent, and
acknowledge by my signature that my son/daughter ___________________________________ of
Grade ____ Section_____ will join the Municipal Drum and Lyre Competition to be held at Jabonga,
Agusan del Norte on July 1, 2023.
I am aware of the usual risks and dangers inherent in the said contest thus, accidents can
occur with or without any fault on either part of the student, or the teachers where the contest is
taking place. By allowing my child to participate in this activity, I accept the risk or any untoward
incident, and conform to the school rules and regulations that this activity is suitable for my son or
daughter in order to enhance his/her skills as a student.
I have read and understood the terms of this consent and waiver , and understood well
that is binding upon me, my heirs, executors and administrators.

Date: ____________

_______________________________ ____________________________
Signature of Student-Participant Signature of Parent-Gurdian

Address: Bangonay, Jabonga, Agusan del Norte

Telephone Number: (085) 803-0127
Email Address: adn.bangonaynhs@deped.gov.ph
Facebook: Bangonay NHS