Republic of the Philippines

Department of Education
Region IX, Zamboanga Peninsula
SCHOOLS DIVISION OF ZAMBOANGA DEL SUR
DUMINGAG II DISTRICT
Annex 2
Parent’s Consent Template

Date:

PARENT/LEGAL GUARDIAN CONSENT

I/We hereby willingly and voluntarily give consent to the participation of

my/our son/daughter________________________in the Learning Camp from
______________________.

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

Signature of Father over Signature of Mother over

Printed Name and Date Printed Name and Date

Signature of Guardian over

Printed Name/Date

Relationship with the Learner

Verified by: Date:

_______________________________
Teacher