PARENTAL CONSENT AND WAIVER FORM

I hereby willingly and voluntarily consent the participation of my son _____________

who is a _________________ student in _____________________________________ to
participate in the ______________________________________ to be held at
_________________________________________________on _________________________.
As the elected SSG Officer of his school, I have considered the benefits that he will
derive from his participation in this activity with the understanding that I will not hold any party
responsible for any untoward incident which may happen to my son during the above mentioned
activity as long as due care and precautions are observed to ensure the safety of the participants.
I hereby affix my signature this _________________________________ at
____________________________________________________________.

________________________________________________________
Parent’s/Guardian’s Signature Over Printed Name

_______________________________________
Parent’s/Guardian’s Contact Number (if any)