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Parental Consent 2024 007

This document is a parental consent form for a child to participate in the 2024 Division Learners’ Camp on November 28-29, 2024, at Peñaplata Central Elementary School SPED Center. The parent acknowledges understanding the potential risks and agrees not to hold the Department of Education liable for unforeseen incidents. The form also includes authorization for the processing of the child's personal information in compliance with the Data Privacy Act of 2012.

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Menjie Antiporta
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84 views1 page

Parental Consent 2024 007

This document is a parental consent form for a child to participate in the 2024 Division Learners’ Camp on November 28-29, 2024, at Peñaplata Central Elementary School SPED Center. The parent acknowledges understanding the potential risks and agrees not to hold the Department of Education liable for unforeseen incidents. The form also includes authorization for the processing of the child's personal information in compliance with the Data Privacy Act of 2012.

Uploaded by

Menjie Antiporta
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Republic of the Philippines

Department of Education
DAVAO REGION
SCHOOLS DIVISION OF ISLAND GARDEN CITY OF SAMAL

PARENTAL CONSENT

I, the undersigned, hereby willingly and voluntarily give full consent for my
child, ______________________________________________, to participate in the 2024
Division Learners’ Camp on November 28-29, 2024 at Peñaplata Central
Elementary School SPED Center.

I have thoroughly considered the potential benefits that my child will


derive from their participation in this activity, and I fully understand that the
personnel of the Department of Education (DepEd) cannot be held liable for any
unforeseen incidents or circumstances beyond their control. However, I have
confidence that the DepEd personnel will exercise due care, diligence, and
necessary precautions to ensure the health and safety of my child.

Furthermore, I hereby authorize the personnel of the Department of


Education to collect, process, retain, and dispose of the personal information of
the learner in strict accordance with the provisions outlined in the Data Privacy
Act of 2012.

I acknowledge that this consent form remains valid throughout the


duration of the event, and I understand that I have the right to revoke this
consent in writing at any time, provided that sufficient notice is given to the
relevant authorities.

By signing below, I affirm that I have read and understood the contents of
this consent form, and I willingly and voluntarily provide my consent as
indicated.

______________________________________________
Name and Signature of Parent/Guardian

_________________________________________
Contact Number

________________________________________
Date

Address: Sitio Pasig, Brgy. Peñaplata, District II, Island Garden City of Samal
Contact No.: 0905-441-7212
Email Address: samalcity@deped.gov.ph

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