Community Extension Service

PARENT’S CONSENT FORM

October 19, 2019
Date: _____________________

I, the parent/guardian of , do
allow my son/daughter to join the activity specified below that is organized by the USC -
Community Extension Services for the USC Days 2019 celebration.

TITLE OF THE
CPDRC Mission Operations 2019
ACTIVITY
VENUE/LOCATION CPDRC, Brgy. Kalunasan, Cebu City

DATE October 23, 2019 (Wednesday)

TIME COVERAGE 06:00AM to 05:00 PM

I am conscious of the risks and benefits involved in this activity. Having obtained
permission, my child has the responsibility of safeguarding himself/herself in the entire
duration of the activity.

Sincerely yours,

Name and Signature of Parent/Guardian and Date

Control No.: