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Revised as of September 26, 2019

Republic of the Philippines


DEPARTMENT OF EDUCATION
________________________________
Region
____________________________________
Division
_____________________________________________________
School
_____________________________________________________
School Address

_______________________
Date

CERTIFICATE OF COMMITMENT

I, __________________________________, of legal age, single/married/widow,


(Name of Chaperon)

Filipino citizen, and presently working as ___________________________________


(Position)

at ________________________________________, hereby commit myself to nurture


(Work Address)

the athletes of ___________________________, provided that due care and


(Name of Event)

precaution will be observed to ensure the comfort and safety of the athletes

until the last day in the Lower Meet up to the Palarong Pambansa.

That I will not interfere in the Coaching of our Team or Act as Coach of

the Athlete as it is not my responsibility to do so.

_______________________________________
Signature over Printed Name of Chaperon

Verified:

________________________________
School Head
(Signature Over Printed Name)

FOR SCHOOL SPORTS (Lower Meet up to Palarong Pambansa)