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    Sworn Statement of Actual Care and Custody Revised

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    AlbertoPeralta
    This document is an affidavit providing consent for a minor child's participation in school sports competitions. It states that [1] Alberto A. Peralta has actual care and custody of the minor child since both parents are deceased. [2] As caretaker and custodian, Mr. Peralta consents to the child's participation in division, regional, and Palarong Pambansa meets, provided due care is taken for the child's safety. [3] Potential benefits to the child are acknowledged, and the Department of Education is not responsible for unforeseen incidents beyond their control.

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    Sworn Statement of Actual Care and Custody Revised

    Uploaded by

    AlbertoPeralta
    51 views1 page
    This document is an affidavit providing consent for a minor child's participation in school sports competitions. It states that [1] Alberto A. Peralta has actual care and custody of the minor child since both parents are deceased. [2] As caretaker and custodian, Mr. Peralta consents to the child's participation in division, regional, and Palarong Pambansa meets, provided due care is taken for the child's safety. [3] Potential benefits to the child are acknowledged, and the Department of Education is not responsible for unforeseen incidents beyond their control.

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    Original Title

    SWORN-STATEMENT-OF-ACTUAL-CARE-AND-CUSTODY-REVISED

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    This document is an affidavit providing consent for a minor child's participation in school sports competitions. It states that [1] Alberto A. Peralta has actual care and custody of the minor child since both parents are deceased. [2] As caretaker and custodian, Mr. Peralta consents to the child's participation in division, regional, and Palarong Pambansa meets, provided due care is taken for the child's safety. [3] Potential benefits to the child are acknowledged, and the Department of Education is not responsible for unforeseen incidents beyond their control.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    51 views1 page

    Sworn Statement of Actual Care and Custody Revised

    Uploaded by

    AlbertoPeralta
    This document is an affidavit providing consent for a minor child's participation in school sports competitions. It states that [1] Alberto A. Peralta has actual care and custody of the minor child since both parents are deceased. [2] As caretaker and custodian, Mr. Peralta consents to the child's participation in division, regional, and Palarong Pambansa meets, provided due care is taken for the child's safety. [3] Potential benefits to the child are acknowledged, and the Department of Education is not responsible for unforeseen incidents beyond their control.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Republic of the Philippines

    DEPARTMENT OF EDUCATION
    Reginal Office ___
    Schools Division of _________
    AFFIDAVIT/SWORN STATEMENT OF ACTUAL CARE AND CUSTODY
    I, Alberto A. Peralta , resident of P2 Raniag, Ramon, Isabela , of legal
    age, Filipino state that:

    1. I have the actual care and custody of minor child _____________________, who is
    my_____________ (filial relationship to the child, if any).

    2. I further state that the actual care and custody was vested upon me since
    ______________ because
    ______ both parents of the minor child died;
    ______ the known parent died; (Proof - Death Certificate)
    ______ both parents are unknown. (Proof – Certificate of Foundling)
    ______ other scenario in cases one or both parent cannot sign the necessary
    Parental Consent form;
    ________________________________________________________________________
    As the actual caretaker and custodian of the minor child, I hereby willingly and
    voluntarily give consent to the participation of the minor child in the school sports athletic
    meets which includes, but not limited to Division Meet, Regional Meet and Palarong
    Pambansa.

    3. I have considered the benefits that the minor child will derive from the
    participation in these activities provided that due care and precaution shall be
    observed to ensure the comfort and safety of the minor child.

    4. I hereby acknowledge that Department of Education, its management,


    personnel, employees and agent may not be held responsible for any untoward
    incident which is beyond their control.

    IN WITNESS THEREOF, I have hereto affixed my signature this ________________ in


    _______________________.

    ALBERTO A. PERALTA A
    Printed Name over Signature
    Verified:

    _____________________________ EFREN L. SANTIAGO


    Adviser School Head/Registrar
    (Signature Over Printed Name) (Signature Over Printed Name)

    SUBSCRIBED AND SWORN to me this ______________________ by ____________________ in


    _________________________ who I have identified through his/her competent proof of
    identification.

    _____________________________
    NOTARY PUBLIC

    FOR SCHOOL SPORTS (Lower Meet up to Palarong Bayan)

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