CONSENT FOR THE PROVISION OF CHILD DEVELOPMENT CENTER
WE/I
age/s, resident of
the minor
at
and
of legal
Urbiztondo, Pangasinan are / is the parent/s/guardian of
the said minor was born on
Per MSWD office basic requirements, minor is found eligible for Child Development Service and
referred at Bituag Child Development Center by Mrs. Elma C. Delos Reyes Child Development Teach-
er.
That we/I consent to the provision of the said service to our/ my child for the stated period herein.
That we/I will provide support the different activities and continue such activities at home in order
to attain the objectives of the Child Development Service for the welfare of our/ my child.
That we are willing to pay the registration fee in the amount 100.00 and a monthly fee in the
amount of 50.00.
That we will report difficulties/problems to the Social Worker/ Child Development Teacher and
cooperate with them to solve said problem/s.
That this content was explained to us and fully understand its implications.
Issued on
Pangasinan.
of
2024 at Bituag Child Development Center, Urbiztondo,
​