REPUBLIC OF THE PHILIPPINES

DEPARTMENT OF EDUCATION
REGION V
Division of City Schools Naga City
District VI
CONCEPCION GRANDE ELEMENTARY SCHOOL

PARENTAL CONSENT AND WAIVER FORM

I, __________________________, grant permission for my son/daughter, _______________________, to

participate in the Arbor Day as in line with the 70 th (Platinum) Charter Anniversary Celebration of the city of Naga,
wherein a tree planting will be held at Mt. Isarog Natural Park (near GSP Camp site) on June 16, 2018 (Saturday) at
Plaza Quezon. This activity will take place under the guidance and direction of the Temporary AP Coordinator, Ms.
Myrian E. Calleja, School’s Supreme Pupils Government (SPG) adviser, Ms. Leah Delos Santos and School’s Paper
adviser, Mr. Ariel V. De La Cruz.

A brief description of the event follows:

Location of event: Mt. Isarog Natural Park, Nabuntulan Watershed,

Barangay Panicuason, Naga City
Assembly Area: Plaza Quezon
Time: 6:30-6:40 am (Car pooling & MNWD service)

Departure going to Panicuason

Time: 7:00-7:40 am
Opening Program
Area: Nabuntulan Watershed
Time: 8:00-8:15 am
Tree Planting Proper: Mt. Isarog Natural Park
Time: 10:00-11:00 am
Home sweet home: 11:00-11:30am

I, as parent and/or legal guardian, remain legally responsible for any personal actions taken by the above named
participant.

_______________________________ __________________________
Parent/Guardian over Printed Name Date

Home Address: ____________________

Contact No(s): ____________________