Enclosure No. | to Division Memo No. 5.2019 on. Republic ofthe Philippines ; % Depariment of Education ¥ 2 Region VI~ Westem Visayas Ss DIVISION OF AKLAN SIZE?” archbishop Gabriel M. Reyes Slreet, Kalibo, Akon INDIVIDUAL REGISTRATION FORM. Name: Nickname: Age: Sex: Grade Level Religion: Mobile Phone No.: Schoo! - School Address: Emergency Contact Person: Address: Contact No.: liven Live Out Medical Conditions); Allergies: Food Restriction: Noted by: School Head PARENTAL CONSENT I hereby allow my son/daughter to participate in the Supreme Student Government Leadership Training and Skills Development Workshop on June 10 fo 12, 2019 at Governor Corazon L. Cabagnot Tourism and Training Center (GCLCTIC), Old Buswang, Kalibo, Aklan. This is to further certify that | will not hold the organization responsible for any untoward incident that may happen beyond their control as long as utmost care and precaution will be undertaken. ~ Signature over Printed Name Name of Parent/Guardian