Republic of the Philippines

PAMANTASAN NG LUNGSOD NG MAYNILA

(University of the City of Manila)
Intramuros, Manila
Telefax No. 526-68-82
OFFICE OF THE STUDENT DEVELOPMENT AND SERVICES
COLLEGE

: College of Engineering and Technology

ACITIVITY

: __________________

DATE

TIME

:____5:00 10:00 PM

VENUE

__________________

________________________________

: Cherry Blossoms Hotel, J. Bocobo Ext., Ermita,

Manila
REMARKS

______________________________________________________________________________
PARENTAL CONSENT
We allow our son/daughter _
_____________________________with
Student Number _
_ from (College) College of Engineering and Technology
taking up (degree program) ___BS Chemical Engineering____ to join the
______________ _ on _______________________ at _Cherry Blossoms Hotel, Ermita,
Manila_.

We voluntarily and knowingly waive all rights of actions against the school,
its faculty member/s. employees. officials, and administrators for any injury
or damage, as well as costs, expenses and liabilities which may incur during
or as a result of the event / field trip.
In case of emergency:
Name of contact person
:
__
________________________
Relationship
:
__
_____________________________
Contact Number
:
__

______________________________

We dont allow our son / daughter _____________________ to join the

event/fieldtrip.

______________________________________
PARENTS SIGNATURE OVER PRINTED NAME

___________________
DATE

Note: Not valid without the photocopied parents identification card.