PARENTAL CONSENT FOR EDUCATIONAL TOUR

AND EXPERIENTIAL LEARNING ACTIVITY

Student Name: Janine Aira I. Calabano

Date of Birth: January 9, 1999
Course: Bachelor of Science in Tourism Management Year and Section: BSTM III

Educational Tour: Educational Tour and Experiential Learning Activity

Bataan-Corregidor
April 4, 5 and 6, 2018

Cost: P 9,899

School/ College: Institute of International Hospitality Management and Tourism

St. Anne College Lucena, Inc., Diversion Rd., Lucena City

Travel Agency: Crown Point Travel & Tours

Hermana Fausta cor. Enriquez St. Lucena City

I, the parent/legal guardian of the above named student, agree to his/ her participation in the
educational tour identified above. Furthermore, I recognize that the Code of Conduct currently in
place in this school will be enforced as part of this educational tour. I recognize that there may
be certain academic and/ or behavioral requirements for participation in this experiential
learning activity and that all participants must meet these requirements to take part in this
educational tour.

Finally, I agree that the above named student is fit and I allow him/her to join this educational
tour based on medical clearance from a physician.

Parent/ Guardian Name and Signature: JEANY E. ILAN

Relationship: Mother Date: March 5, 2018
Government Issued Identification Card Number: PHILHEALTH 190258360315
Home Address: Brgy. Mateuna Tayabas, City
Telephone: none Cell Phone: 09483505387/09151246738

Notarization Section:

On this ____ day of _______________, before me, the undersigned notary public,
personally appeared ________________________________________________________
(name of document signer), proved to me through satisfactory evidence of identification , to be
the person whose name is signed above, and swore or affirmed to me that the contents of the
document are truthful and accurate to the best of his/her knowledge and belief.

Signature of Notary Public

Notary Seal