Annex 2

Parent’s Consent Template

Republic of the Philippines

Department of Education
Region V – Bicol
Schools Division Office of Legazpi City
School name
Address

________________________
Date

P A R E N TA L CONSENT

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter ______________________________________ in the Learning Camp from
________________________.

I have considered the benefits that my son or daughter will get from his/her participation in
this activity provided that due care and precaution will be observed to ensure the comfort
and safety of my son/daughter, DepED employees and personnel may not be held
responsible for any untoward incident that may happen beyond their control.

___________________________ ____________________________
Signature of Father over Signature of Motherover
printed Name and Date printed Name and Date

____________________________________
Signature of Guardian over
Printed Name and Date

____________________________________
Relationship with the Learner

Verified by:

__________________________ Date: ____________________

Teacher

Note: If No Parent/s, submit Affidavit of Guardianship duly verified by the teacher. If parents are
abroad, a Special Power of Attorney (SPA) is needed.