Girl Scouts of the Philippines

Central Luzon Region

PASIG CITY GIRL SCOUT COUNCIL
2F Data Archive Bldg., City Hall Complex, Pasig City

PARENT’S CONSENT & WAIVER

I, ___________________________________ (name of parent), parent of ___________________________

(participant’s name) ____ y.o., (participant’s age) _________________________ (Age-level) of Troop no.

_________ from _________________________________________ (school) allows my daughter to join the

________________________________________________________________________________________

(GSP Activity) that will be held on _____________________ (date of Activity) at_______________________

______________________________________________________________________________ (event place).

I acknowledge that my child/children’s participation in this activity is completely voluntary.

I understand that the minimum public health standards set by the government to minimize the risk of
spreading COVID-19 will be implemented. Guidelines and procedures set by the Department of
Education and other government agencies will be adhered to.

_________________________________________

PARENT’S SIGNATURE OVER PRINTED NAME

DATA PRIVACY CONSENT

To ensure the safe and transparent usage of your personal information, we require that you read and
fully understand the provisions stated in this document. This is in compliance with the Republic Act 10173,
also known as the Philippine Data Privacy Act of 2012, whose implementing rules and regulations took effect
on September 9, 2016. We are providing you with this letter to inform and secure your consent. You may
access the Basic Rights of the Data Subject through this link: https://privacy.gov.ph/data-privacy-act.

1. I authorize the Pasig City Girl Scout Council to collect, use, share, retain and/or process (my / my
daughter’s) information for my participation in the
__________________________________________ (GSP Activity/Event).
2. I allow the Pasig City Girl Scout Council to use pictures or films of (my / my daughter’s) story for
any purpose, and in any way, that assists the organization’s work in keeping their Movement thriving,
united and growing;
3. I understand that the Pasig City Girl Scout Council may use, reproduce and distribute all or any part
of the photographs, films or interviews on any traditional or electronic media format to GSP official
multi-media account.

_________________________________________

SIGNATURE OVER PRINTED NAME

_________________________
DATE

Troop Leader: ____________________________________