SAINT LOUIS UNIVERSITY Baguio City PARENT'S CONSENT FORM ORGANIZATION/SCHOOL DELEGATION/CLASS:_PICHE - JOLUC. = School of SERA - — ~ - WHEREAS, the Orgarization/Ctass will hold the __Che mia for its members on (date) April. 30, 2014.____fromlinclusve time) at(place)_DECMEDT. OVAL MARYHEIGHT CANIN BAKAKENG which is BEYOND REGULAR ACADEMIC SCHEDULE, specifically (please CHECK): —Z1.ON-CAMPUS, a. class day after @:45P.M. upto Tb HySunday /( ) Holiday /( } No-cass but office day WHEREAS, the actvtyis aimed to _forker a _utle of family _wttan the _deparner'!_thugh reat ead _Imovate—sagensst? Wil alo bean avnde g—ehablehing velworks “and Th reagilany teaatenet Ly ~ ~ ~ ~ he ARO WHEREAS, the university allows this activity only upon the free volition of the students with the assurance that the parents/legal guardians are adequately informed about as attested to by the duly accomplished Parent's Consent Form, as well as with the supervision by their Faculty Adviser(s) who faithfully and honestly observe the diligence and care within the bounds of the law to prevent any untoward incident/s, to uphold the rules and regulations of the University governing such activity and the violation thereof will make the person/s concerned liable thereof WHEREAS, the rules and regula! ns also governing the activity are as follows: A. For ADVISERS): 1. Noundue press ever is exerted on any student, either directly oF incirecti, In order to participate; 2. The advisers dligently guide the students in accordance with prudence and as per rules and regulations ofthe stool governing out-of ‘school activities ang the conduct of students outside the schoo 3. Theresponsilitios ofthe advisers are limited only atthe vory start ofthe activity untilite over 4, The advisers are responsible only forthe consequences due to negligence on their part 5. Theadkiser isnot lable for any untoward incident due to '2. Violation of the stusent/s of rules ané regulations or the instructions; b. negligence on the part ofthe student/s; ‘© unforeseen events by nature; 4. his absence, that is rot covered by the period covered; £ force majeure, including civil disturbances or rots; and assumption of rsk by the students; For STUDENTS): ss by seh! rules and regulation 2. The students are requires to observe and follow the policies, rules and regulations of the unersity as stated in the Student Handbook ‘egarding a bonafie Lovisian and his/her conduct and behavior; 3. The students are roquited to observe and follow the rogulations and instructions imposed by the adviser/s before and/or during the activity as warranted) 4, _Thestudent i responsible for any act or untoward incident if the couse i: 2. Due to negligence on his/her part b. Violation of A1,A.2, A. above and/or AS above . Not covered by the periog defined under the advisers duties and responsibilities; and 5. The student participates only WITH parental/guardian’s CONSENT successfully obtained, and on voluntary basis foo, ave read and understood a at (plac — scheduled on (date) ‘wil faithfully observe and follow the above provisions to achieve the abjectives of the activity and to 1e above provisions regarding the ‘any untoward incident attested ; balck JANICE OMA —— pea ai ADVISER'S/INSTRUCTOF ‘Siudents Signature over PAINT ORIGINAL SIGNATURE OVER PRINTED NAME Date: PARENT'S APPROVAL AND CONSENT 10 ALLOW my child/ward to join the __ which will be held on at _ — ‘and will not hold the University and/or its officers liable for any untoward incident that may arise as | have, on my part, personally given and reiterated to him/her the pre-eminent and continuing exercise of prudence and personal diligence over his/her own safety in close coordination with the adviser/s pursuant to the rules and regulations as stipulated above. Or ON BEHALF of the parents: aN AT'S Signature over PRINT Signature over PRINTED NAME LEGAL GUARDIAN with CONTACT NUMBER. Pye0ts Contact Number FACULTY ADVISER To the student: S ‘URetuen to your Adviser this duly accomplished Parent's Consent Form attached to the organization's duly accomplished a rm oF the organization’s/schoo! deiegation's/class’s application for permission to hold the out-of- campus activity from the SW President end before particioating in the activity, Please attach nt’sflegal guardian’s/aduiser’s