Annex 2
Parent’s Consent Template
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region V Bicol
Division of City Schools
DON LAZARO MADARA MEMORIAL SCHOOL
San Nicolas Ilian, Iriga City
__________________________
PARENTAL GUARDIAN CONSENT
I/We hereby willingly and voluntarily give consent to the participation of my/our son/daughter
______________________________________ in the Learning Camp from July 01 -19, 2024.
Name of Learner (Dates of Attendance)
I have considered the benefit that my son/daughter will get from his/her participation in this activity provided
that due care and precaution will be observed to ensure the comfort and safety of my son/daughter. DepEd
employees and personnel may not be held responsible for untoward incidents that may happen beyond their
control.
_________________________ _________________________
Signature of Father’s Over Signature of Mother’s Over
(Printed name and Date) (Printed Name and Date)
_______________________________
Signature of Guardian’s over
Printed Name/Date
_________________________________
Relationship with the Learner
Verified By:
AIZA N. CLET Date:
_______________________
Teacher
Note: If No Parent/s, submit Affidavit of Guardianship duly signed by the teacher. If parents are abroad a
Special Power of Attorney/SPA is needed.
Annex 1
Learning Camp Registration Template
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region V Bicol
Division of City Schools
IRIGA CITY DIVISION
DON LAZARO MADARA MEMORIAL SCHOOL
San Nicolas Ilian, Iriga City
Learning Camp Registration Template
Camp Group: _____________________________________
Name: _____________________________________
Grade Level: _____________________________________
If in Senior High School, specify the strand______________________________________
Age: _____________________________________
Address: _____________________________________
Parent/Legal Guardian: _______________________________
Contact Number: ____________________________________
Final Grades in English________________________________
Math_________________________________
Science_______________________________
Annex 1
Learning Camp Registration Template
Republic of the Philippines
DEPARTMENT OF EDUCATION
Region V Bicol
Division of City Schools
IRIGA CITY DIVISION
DON LAZARO MADARA MEMORIAL SCHOOL
San Nicolas Ilian, Iriga City
Learning Camp Registration Template
Camp Group: _____________________________________
Name: _____________________________________
Grade Level: _____________________________________
If in Senior High School, specify the strand______________________________________
Age: _____________________________________
Address: _____________________________________
Parent/Legal Guardian: _______________________________
Contact Number: ____________________________________
Final Grades in English________________________________
Math_________________________________
Science_______________________________