Republic of the Philippines

Department of Education
REGION VIII – EASTERN VISAYAS
DIVISION OF BILIRAN
CAPIÑAHAN ELEMENTARY SCHOOL
CAPIÑAHAN, NAVAL, BILIRAN

PARENT / LEGAL GUARDIAN CONSENT FORM

I hereby willingly and voluntarily give consent to the participation of my son/daughter
_______________________ in the Learning Camp from July 1, 2024 to July 19, 2024.

I have considered the benefits that my son/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 incidents that may happen beyond their control.

_______________________________
Signature of Parent/Guardian over
Printed Name

_______________
Date

Verified by:

BLESZEL B. VILLAMOR
NLC Teacher

____________
Date