_____________________________

Name of Student

I _____________________________, the guardian of ____________________________, do

hereby give our consent for my son/daughter to conduct any form of interview with any
personnel from the community inside the National Bilibid Prison held on ________________ at
_______________.

I hereby agree not to hold the school and any individual employed by the school
liable for any expense, loss, personal injury or accident to my son/daughter which is not the result
of any negligent act or willful default of any employee or agent of the school.

____________________________________
Parent’s signature over printed name

Noted by:

Ar. Jeruel Barlis Almina T. Tengco

Class Adviser Head, Architecture Department, OIC Dean