Revised as of September 26,
2019 Republic of the Philippines
DEPARTMENT OF EDUCATION
I
(Region)
LA UNION
(Division)
BURGOS NATIONAL HIGH SCHOOL
(School)
NEW POBLACION, BURGOS, LA UNION
(School Address)
2/28/2025
Date
PARENTAL CONSENT
I/We hereby willingly and voluntarily give consent to the participation of
my/our son/daughter _________________________ in joining the POST-
PERFORMANCE PICNIC attended by the BNHS Cultural Dancers at
KANANASKIS MOUNTAIN RESORT, DALACDAC, BURGOS, LA UNION
on March 1, 2025 at 8:00 am -5:00pm
I/We am aware of the usual risks inherent in the said activity thus,
accidents can occur with or without the fault on either the part of the student
or the teachers where the activity is taking place.
By allowing our child to participate in this activity, I/We accept the risks
or any untoward incident, and agree to conform to the school’s rules and
regulations, thus the school has no accountability. This activity is a
commendation of my son/daughter’s effort for representing the school during
the 2025 BOYBOY Festival.
I have read and understood the terms of this consent and waiver,
which are binding upon me/us my heirs, executors and administrators.
Signature of Father Over Printed Name Signature of Mother Over Printed Name
Verified:
ELVIE GAVINO-COYTOP, Ed. D
School Head
(Signature Over Printed Name)
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.