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    Sworn Statement of Guardian

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    Aira Rose Crencia Cabaron
    This document is an affidavit of actual care and custody for a minor child athlete. It states that [NAME OF GUARDIAN] has actual care and custody of the minor child [NAME OF ATHLETE] and has had custody since [DATE] because both parents are deceased/unknown. As the legal guardian, they consent to the child's participation in school sports competitions including division, regional, and national meets. The guardian acknowledges that the Department of Education is not responsible for any incidents beyond their control during the competitions.

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    © All Rights Reserved
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    Sworn Statement of Guardian

    Uploaded by

    Aira Rose Crencia Cabaron
    68 views1 page
    This document is an affidavit of actual care and custody for a minor child athlete. It states that [NAME OF GUARDIAN] has actual care and custody of the minor child [NAME OF ATHLETE] and has had custody since [DATE] because both parents are deceased/unknown. As the legal guardian, they consent to the child's participation in school sports competitions including division, regional, and national meets. The guardian acknowledges that the Department of Education is not responsible for any incidents beyond their control during the competitions.

    Original Description:

    ATHLETE FORMS

    Original Title

    SWORN STATEMENT OF GUARDIAN

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    This document is an affidavit of actual care and custody for a minor child athlete. It states that [NAME OF GUARDIAN] has actual care and custody of the minor child [NAME OF ATHLETE] and has had custody since [DATE] because both parents are deceased/unknown. As the legal guardian, they consent to the child's participation in school sports competitions including division, regional, and national meets. The guardian acknowledges that the Department of Education is not responsible for any incidents beyond their control during the competitions.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    68 views1 page

    Sworn Statement of Guardian

    Uploaded by

    Aira Rose Crencia Cabaron
    This document is an affidavit of actual care and custody for a minor child athlete. It states that [NAME OF GUARDIAN] has actual care and custody of the minor child [NAME OF ATHLETE] and has had custody since [DATE] because both parents are deceased/unknown. As the legal guardian, they consent to the child's participation in school sports competitions including division, regional, and national meets. The guardian acknowledges that the Department of Education is not responsible for any incidents beyond their control during the competitions.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Revised as of September 26, 2019

    Republic of the Philippines


    DEPARTMENT OF EDUCATION
    Regional Office XIII
    Schools Division of Agusan del Norte

    AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE AND CUSTODY

    I _________________________________,
    NAME OF GUARDIAN resident of ____________________________,
    ADDRESS of legal
    age, Filipino state that:

    1. I have the actual care and custody of minor child _________________________,


    NAME OF ATHLETE
    who is my_________________
    RELATIONSHIP (filial relationship to the child, if any).

    2. I further state that the actual care and custody was vested upon me since
    _______________________
    SINCE WHEN?/DATE because

    ______
     both parents of the minor child died;
    ______ the known parent died; (Proof - Death Certificate)
    ______ both parents are unknown. (Proof – Certificate of Foundling)
    ______ other scenario in cases one or both parent cannot sign the necessary
    Parental Consent form;
    ________________________________________________________________________
    ________________________________________________________________________
    ________________________________________________________________________

    3. As the actual caretaker and custodian of the minor child, I hereby willingly and
    voluntarily give consent to the participation of the minor child in the school
    sports athletic meets which includes, but not limited to Division Meet, Regional
    Meet and Palarong Pambansa.

    4. I have considered the benefits that the minor child will derive from the
    participation in these activities provided that due care and precaution shall be
    observed to ensure the comfort and safety of the minor child.

    5. I hereby acknowledge that Department of Education, its management,


    personnel, employees and agent may not be held responsible for any untoward
    incident which is beyond their control.

    IN WITNESS THEREOF, I have hereto affixed my signature this


    ____________________________
    DATE OF SIGNING in ___________________________.
    PLACE

    _____________________________
    NAME OF GUARDIAN
    Printed Name over Signature
    Verified:

    _____________________________
    NAME OF ADVISER _____________________________
    NAME OF SCHOOL HEAD
    Adviser School Head/Registrar
    (Signature Over Printed Name) (Signature Over Printed Name)

    SUBSCRIBED AND SWORN to me this ______________________ by


    ____________________ in _________________________ who I have identified through his/her
    competent proof of identification.

    _____________________________
    NOTARY PUBLIC

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)

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