2 Revised as of September 26, 2019
Republic of the Philippines
DEPARTMENT OF EDUCATION
NCR
Region
QUEZON CITY
Division
BATASAN HILLS NATIONAL HIGH SCHOOL
School
IBP ROAD, BATASAN HILLS Q.C
School Address
MARCH 23, 2023
Date
PARENTAL CONSENT
I/we hereby willingly and volutarily give consent to the participation of my/our son/daughter
JUSTINE N. CAMO in TAEKWONDO in all School
Sports Meets up to Palarong Pambansa
I/We have concidered the benefits of my son/daughter will derive from his/her participation in
this activity provided that due care, diligence and necessary precautions will be observed to ensure
his/her health and safety.
Further, I/We authorize the personnel of Department of Education to collect, process, retain and
dispose personal information above the mentioned athlete in accordance to Data Privacy Act of 2012.
TREB MIRAS JANNETH CAMO
Signature of Father over Printed Name Signature of Mother over Printed Name
Verified :
MS. LOURDES MORAN DR. ELADIO H. ESCOLANO
ADVISER PRINCIPAL
Remarks
Note: Submit the necessary documents, i.e. Affidavit/Sworn Statement of Actual Care
and Custody duly verified by the adviser and school head, in cases signature of parents
are unavailable
FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)
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nsure
and
of 2012.