Parents-Consent.docx

1. Republic of the Philippines
Department of Education
Region X – Northern Mindanao
Cagayan de Oro City
WEST I District
MACANHAN ELEMENTARY SCHOOL
PARENTAL CONSENT FORM FOR THE FACE-TO-FACE MODALITY
I ___________________________________the parent or legal guardian of
__________________________________hereby acknowledge that I have been informed of the
details of the implementation of Face-to-Face Learning Modality and I have given
permission of my son/daughter to participate in the Face-to-Face Learning Modality
Classes.
I understand that Macanhan Elementary School shall implement the minimum public
standards set by the government to minimize risk of the spread of COVID-19.
Name of Parent/Guardian: ___________________________________
Signature: ___________________________________________________
Date Signed:__________________________________________________
Contact Details: ______________________________________________
Name of Child: _______________________________________________
Address: _____________________________________________________
HOUSEHOLD COVID VACCINATION STATUS
Name of Family Member Age Relationship
to Learner
COVID Vaccination Status (Please check)
1st Dose 2nd Dose Booster Unvaccinated