PARENTAL CONSENT

GOV. BEN P. EVARDONE CUP – SEASON 5

(The Inter-Municipality/City Basketball & Volleyball
Tournament for the Province of Eastern Samar)

CERTIFICATION
This is to certify that I __________________________________ (Full
Name), am the parent/legal guardian of _______________________________
(Name of Player) playing ___________________ (Name of Event) for the
City/Municipality of _____________________.

As such, I attest to the veracity of his/her documents submitted and to

his/her fitness to play based on the rules on qualification required for the
Tournament, specifically on age limit (that he/she is not yet 17 years of age
before March 23, 2024).

I further attest that my son/daughter/legal child is physically fit and

healthy to play for the event he/she is participating and hold the organizing
committee not responsible for any untoward incident that may happen, whether
on or off the playing court, of which it has no direct control or supervision.

Signature

SUBCRIBED AND SWORN TO before me this ______ day of

______________ 2024 in ____________________________, affiant exhibiting
to me his/her ___________________ ____________.

Doc. No. _____;

Page No. _____; NOTARY PUBLIC
Book No. _____;
Series of 2024.