PARENT’S / GUARDIAN CONSENT AND WAIVER FORM

TO ALL CONCERNED:

I, _________________________________ grant permission for my child/ward

____________________________, a_______________ student of _________________ of the
__________________ of this University, to attend the midterm class.

Inherent risks are associated with any activity and by granting permission for
my son/daughter to attend his/her midterm class; I acknowledge that such risks
exist. However, I believe that the opportunity for learning outweighs these risks.

If in case that he/she is a minor, I, as the parent/legal guardian will take

full accountability on any and all liabilities occasioned by his/her intentional
or negligent act while in the course of the implementation of the program.

________________________________________
Parent’s/Guardian’s signature over printed name
Contact Number:__________________________
Address :__________________________

Conforme:
_________________________________
(Student’s signature over printed name)