Republic of the Philippines

PALAWAN STATE UNIVERSITY

Puerto Princesa City

PARENTAL CONSENT

I hereby willingly and voluntarily give consent to the participation in the

___________________________________________________ (Event) of my son/
daughter ___________________________________________________ of the
(College) _______________________________________________________ in
(Venue) ______________________________________________________ on
(Date) _____________________________.

I have considered the benefits that my son/daughter will derive from his/her
participation in this activity with the understanding that due care and precaution will be
observed to ensure the comfort and safety of the delegation and that Palawan State
University (PSU) employees and personnel may not be held responsible for any
untoward incident that may happen beyond their control.

______________________________________
Signature of the Participant over Printed Name

Signature of Parent/Guardian over Printed Name

Verified by:

______________________________
Chairperson/Adviser

_______________________________
College Dean
 Republic of the Philippines
PALAWAN STATE UNIVERSITY
Tiniguiban Heights, Puerto Princesa City

WAIVER

I, the undersigned parent and/or legal guardian of ______________________(name

of student), do hereby consent his/her participation in the
________________________________________________(title of the activity) to be held on
____________________(duration) in _________________________________(location).

I understand that there might be unforeseen circumstances or if foreseen, the same

may be inevitable, during the event. In addition to giving my full consent for his/her participation
to the said event, I do hereby waive, release, and hold harmless the Palawan State
University, its administration, officers, officials and/or employees, for any circumstances
which are inevitable and unforeseen that may arise during the whole duration, including travel
time to and from the event, and for any damages, which I or the student-participant may suffer,
or for which the student-participant may be liable to other person/s and/or institution/s, related
to the student’s participation in the event, resulting from an causes, including but not limited
to the negligence on the part of the student or any of the released parties.

IN SIGNING THE WAIVER, I ACKNOWLEDGE AND REPRESENT THAT I HAVE read

the invitation letter which is hereto attached and made an integral part of this waiver, and the
foregoing waiver.

IN WITNESS WHEREOF, I have hereunto voluntarily set my hand this

______________________ (date) in ___________________________________________,
Philippines (location).

(Signature of the Participant over Printed Name)

(Parent and/or guardian signature over printed name)

Signed in the presence of:

JPIA President JPIA Adviser