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    Parents Consent and Waiver Template

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    MUSA, Kristoffer Louie T.
    Template

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Parents Consent and Waiver Template

    Uploaded by

    MUSA, Kristoffer Louie T.
    16 views1 page
    Template

    Original Title

    PARENTS-CONSENT-AND-WAIVER-TEMPLATE

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    © © All Rights Reserved

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    Template

    Copyright:

    © All Rights Reserved
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    Download as docx, pdf, or txt
    16 views1 page

    Parents Consent and Waiver Template

    Uploaded by

    MUSA, Kristoffer Louie T.
    Template

    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

    UNIVERSITY OF NORTHERN PHILIPPINES


    Tamag, Vigan City
    2700 Ilocos Sur

    COLLEGE OF TEACHER EDUCATION

    PARENT’S CONSENT AND WAIVER

    I AM PERMITTING
    _________________________________________________________________who is my
    (Name of Student: Family Name, Given Name, M.I.)
    _____________________. enrolled in the University of Northern Philippines, Vigan City
    in the course
    (Relationship to the Student)

    __________________________ to go on
    ___________________________________________________________
    (Course and Year) (Title of Activity)

    with the following details:


     Place and Venue of Activity :
    ____________________________________
     Date and Time of Activity :
    ____________________________________
     Name of Supervising Faculty Member :
    ____________________________________
     Contact No. of Supervising Faculty Member :
    ____________________________________
     Amount of Contributions/Payment (if any) :
    ____________________________________
     Diet Restrictions (if any) :
    ____________________________________
     Existing ailment (if any) :
    ____________________________________
     Objectives of the Activity:
    1.
    2.
    3.

    IN SIGNING THIS PARENTAL CONSENT AND WAIVER, I am holding the


    University, its officials, and the supervising faculty free from any liability in the
    event that abovesaid student sustains damages by reason of injuries or untoward
    events inflicted by an act or omission by himself/herself or by a fellow student or a
    third party during the activity or while supervision or control is still present,
    provided that they exercised or observed all the diligence of a good father of the
    family to prevent the damage.

    I HAVE READ AND UNDERSTOOD the terms of this consent and waiver, and
    recognize that is binding upon me.

    __________________________________________ ID
    Number__________________________________
    (Signature Over Printed Name of Parent/Guardian)
    Date Issued:
    __________________________________
    Date Signed: _________________________

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