To whom it may concern:

I am giving my consent for my daughter/son, ___________(name) of ____________________

(section) to participate in the intramurals. The sport he/she will be participating is__________

I am aware that the school does not have personal accident insurance cover for insurance. In the event of an
accident or illness, I authorize school staff to obtain or administer any medical assistance or treatment my
child may reasonably require. Also, I will not hold the school liable for any injuries that incurred during the
intramurals.

Additional Medical Information:

__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________
__________________________________________________________________________________________

Thank you and Mabuhay!

Sincerely Yours,

____________________________
Parents’/Guardian’s Signature