Parental Consent: Department of Education 1 Ilocos Sur Las-Ud Elementary School Las-Ud, Tagudin, Ilocos Sur

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Republic of the Philippines

Department of Education
1
(Region)
Ilocos Sur
(Division)
Las-ud Elementary School
(School)
Las-ud, Tagudin, Ilocos Sur
(School Address)

P A R E N TA L C O N S E N T

Date: 9/12/2018

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter CECILLE MAY MARGARETTE L. BARNACHEA in the
Division, Regional Meet and Palarong Pambansa.
I have considered the benefits that my son or daughter will derive from his/her
participation in this activity provided that due care and precautio n will be observed to
ensure the comfort and safety of my son/daughter and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.

Signature of Father Signature of Mother

RODANTE L. BARNACHEA MARICEL L. BARNACHEA


Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

CHERRY MAY L. HERNANDO


Teacher-Adviser/School Head/Registrar

Remarks:

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
Department of Education
1
(Region)
Ilocos Sur
(Division)
Las-ud Elementary School
(School)
Las-ud, Tagudin, Ilocos Sur
(School Address)

P A R E N TA L C O N S E N T

Date: 0-12-2018

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter HARLEY JAY L. LORZANO in the
Division, Regional Meet and Palarong Pambansa.
I have considered the benefits that my son or daughter will derive from his/her
participation in this activity provided that due care and precautio n will be observed to
ensure the comfort and safety of my son/daughter and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.

(OFW)
Signature of Father Signature of Mother

JAMES LORZANO MICHELLE LORZANO


Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

CHERRY MAY L. HERNANDO


Teacher-Adviser/School Head/Registrar

Remarks:
The mother is working abroad.

FOR PALARONG PAMBANSA ONLY


Note: For combative games, 2 valid IDs of parents with specimen signature should be attached.
Republic of the Philippines
Department of Education
1
(Region)
Ilocos Sur
(Division)
Las-ud Elementary School
(School)
Las-ud, Tagudin, Ilocos Sur
(School Address)

P A R E N TA L C O N S E N T

Date: 9/12/2018

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter HANNAH KHARLA F. CUARESMA in the
Division, Regional Meet and Palarong Pambansa.

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

(SECURITY GUARD-MANILA)
Signature of Father Signature of Mother

WILLIAM CUARESMA SHERYL CUARESMA


Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

CHERRY MAY L. HERNANDO


Teacher-Adviser/School Head/Registrar

Remarks:
The father is working in Manila.

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
Department of Education
1
(Region)
Ilocos Sur
(Division)
Las-ud Elementary School
(School)
Las-ud, Tagudin, Ilocos Sur
(School Address)

P A R E N TA L C O N S E N T

Date: 9/12/2018

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter REYVEN L. VEDANIA in the
Division, Regional Meet and Palarong Pambansa.
I have considered the benefits that my son or daughter will derive from his/her
participation in this activity provided that due care and precautio n will be observed to
ensure the comfort and safety of my son/daughter and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.

Signature of Father Signature of Mother

RANDY VEDANIA MELANIE VEDANIA


Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

CHERRY MAY L. HERNANDO


Teacher-Adviser/School Head/Registrar

Remarks:

FOR PALARONG PAMBANSA ONLY


Republic of the Philippines
Department of Education
1
(Region)
Ilocos Sur
(Division)
Las-ud Elementary School
(School)
Las-ud, Tagudin, Ilocos Sur
(School Address)

P A R E N TA L C O N S E N T

Date: 9/12/2018

I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter CECILLE MAY MARGARETTE L. BARNACHEA in the
Division, Regional Meet and Palarong Pambansa.
I have considered the benefits that my son or daughter will derive from his/her
participation in this activity provided that due care and precautio n will be observed to
ensure the comfort and safety of my son/daughter and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.

Signature of Father Signature of Mother

RODANTE L. BARNACHEA MARICEL L. BARNACHEA


Name of Father Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

Verified by :

CHERRY MAY L. HERNANDO


Teacher-Adviser/School Head/Registrar

Remarks:

FOR PALARONG PAMBANSA ONLY

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