Republic of the Philippines
Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OFFICE OF SAN PEDRO CITY
SAN PEDRO RELOCATION CENTER NATIONAL HIGH SCHOOL
CITY OF SAN PEDRO, LAGUNA
PARTICIPANT’S INFORMATION SHEET
Name
School
Name of School
Paper
Name of School
Paper Adviser
Category
Contact No.
Grade and Section
PARENTAL CONSENT
I/We hereby willingly and voluntarily give consent the participation of my/our son/daughter
___________________________ to attend the DSPC Cliniquing to be held on October 21, 2023 at San Roque
Elementary School, San Roque, City of San Pedro Laguna.
I/We have considered the benefits that 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.
__________________________________ ____________
Signature of Father/Guardian over Printed Name
_______________________________________________
Signature of Mother/Guardian over Printed Name
Noted by:
Erica C. Quiza
School Paper Adviser – The Root
Approved by:
Divina P. Manlangit
HT VI-English/SHS Coordinator
________________________________________________________________________________________________________
_____________________________________
Republic of the Philippines
Department of Education
REGION IV-A CALABARZON
SCHOOLS DIVISION OFFICE OF SAN PEDRO CITY
SAN PEDRO RELOCATION CENTER NATIONAL HIGH SCHOOL
CITY OF SAN PEDRO, LAGUNA
________________________________________________________________________________________________________
_____________________________________