This document is a consent form from a parent allowing their unvaccinated child to attend in-person classes at Limay National High School. The parent acknowledges that the school and student's adviser are not responsible if the child contracts COVID-19 or other illnesses. The parent agrees to ensure their child follows health protocols.

1. Republic ofthe Philippines
DepartmentofEducation
REGION III
SCHOOLS DIVISION OFFICE OF BAT AAN
LIMAY NAT IONAL HIGH SCHOOL
DUALE, LIMAY, BAT AAN
Address: Duale, Limay, Bataan 2103
Telephone Number: (047) 633-6995
Email Address: linah_066@yahoo.com / limaynhs.junior@gmail.com I Facebook: Limay NHS - Junior HS
Date: _____________________________
Mrs. Maricel M. Cantra
8 STE A Class Adviser
Limay National High School
Duale, Limay, Bataan
Ako si ________________________________________, magulang ni _______________,
ng section 8 STE A ay kusang loob na pinapayagan ang aking anak na pumasok sa
paaralan ng Limay National High School ng Face to Face kahit ang aking anak ay
unvaccinated para sa Covid 19.
Sang-ayon po ako sa patakaran na ipinatutupad ng paaralan na, walang
pananagutan ang ang kanyang adviser sa si Ma’am Cantara at ang paaralang Limay
National High School kung sakaling ang aking anak na si
________________________________________, ay magkasakit, mahawa ng Covid 19 virus o
anumang nakahahawang sakit na dala ng virus. Sisikapin ko pong palalahanan sa
tuwina ang aking anak na sumunod sa standard health protocol bilang pag iingat.
_________________________ ____________________________
Lagda ng Magulang Lagda ng Mag aaral
Address ____________________________________________________________________________

2. Republic ofthe Philippines
DepartmentofEducation
REGION III
SCHOOLS DIVISION OFFICE OF BAT AAN
LIMAY NAT IONAL HIGH SCHOOL
DUALE, LIMAY, BAT AAN
Address: Duale, Limay, Bataan 2103
Telephone Number: (047) 633-6995
Email Address: linah_066@yahoo.com / limaynhs.junior@gmail.com I Facebook: Limay NHS - Junior HS

3. Republic ofthe Philippines
DepartmentofEducation
REGION III
SCHOOLS DIVISION OFFICE OF BAT AAN
LIMAY NAT IONAL HIGH SCHOOL
DUALE, LIMAY, BAT AAN
Address: Duale, Limay, Bataan 2103
Telephone Number: (047) 633-6995
Email Address: linah_066@yahoo.com / limaynhs.junior@gmail.com I Facebook: Limay NHS - Junior HS