TFSS Form No.

004 PC

Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
EDREA SHELLEY C. DELA TORRE
in the lower meets
up to Palarong Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

ELMER J. DELA TORRE

Signature of Mother

SHERILL C. DELA TORRE

Name of Father

Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
EOSEF DAVID C. DELA TORRE
in the lower meets up to
Palarong Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

ELMER J. DELA TORRE

Signature of Mother

SHERILL C. DELA TORRE

Name of Father

Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
DANIEL JOHN S. MERA
in the lower meets up to Palarong
Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

VICTOR S. MERA

Signature of Mother

EDEN S. MERA

Name of Father

Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughte
ANGELICA DIZON
in the lower meets up to Palarong Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

Signature of Mother

Name of Father

Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
in the lower meets up to Palarong Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

Signature of Mother

Name of Father

Name of Mother

Signature of Guardian over Printed name

AUNT
(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education

NATIONAL CAPITAL REGION

(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
JAN MATHEW R. MENDEZ
in the lower meets up to Palarong
Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

Signature of Mother

Name of Father

Name of Mother

Signature of Guardian over Printed name

MOTHER
(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
ANGELO V. REGONDON
in the lower meets up to Palarong
Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

Signature of Mother

CELSO N. REGONDON

MARLYN V. REGONDON

Name of Father

Name of Mother

Signature of Guardian over Printed name

MOTHER
(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education

NATIONAL CAPITAL REGION

(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
JHON MARK V. SOSOBAN
in the lower meets up to Palarong
Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

Signature of Mother

EDGAR T. DANAO

MA. VICTORIA V. SOSOBAN

Name of Father

Name of Mother

Signature of Guardian over Printed name

MOTHER
(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
JERICHO S. VERCELES
in the lower meets up
to Palarong Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

Signature of Mother

WILLIE R. VERCELES

MARIA F. SICABALO

Name of Father

Name of Mother

Signature of Guardian over Printed name

AUNT
(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
IVANN RAILEY G. SALINEL
in the lower meets up to
Palarong Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

Signature of Mother

HERBERT A. SALINEL

ONRUBIA G. SALINEL

Name of Father

Name of Mother

Signature of Guardian over Printed name

FATHER
(Relationship with the Athlete)

TFSS Form No. 004 PC

Republic of the Philippines

Department of Education
NATIONAL CAPITAL REGION
(Region)

CITY SCHOOLS - VALENZUELA

(Division)

P A R E N TA L C O N S E N T
I/We hereby willingly and voluntarily give consent the participation of my/our
son/daughter
JESLEY JHON A. SALAS
in the lower meets up to Palarong
Pambansa.
I have considered the benefits that my son or daughter will derive 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 and that DepED employees and
personnel may not be held responsible for any untoward incident that may happen
beyond their control.
Signature of Father

Signature of Mother

Name of Father

Name of Mother

Signature of Guardian over Printed name

(Relationship with the Athlete)