PARENT/GUARDIAN CONSENT

Student Internship Period: _______________________________________________________

Host Training Establishment: _____________________________________________________
Address: ____________________________________________________________________
Coordinator: __________________________________________________________________

Together with my child, I know that the organization and its administration, officers, faculty, and
staff are expected to exercise due diligence required for the safety and well-being of my child
during the program.

The due diligence includes oral and written instructions, given before or during the activity, that
would ensure the safety of my child.

If my child disregards or fails to follow those instructions or should act on his/her own, I, together
with my child shall have no claims against the institution, the organization, faculty, staff-in-
charge of any damage or liability to be sustained to any property or any person.

Signed by:

________________________________________
Student Intern
Signature above Printed Name

________________________________________
Parent/Guardian
Signature above Printed Name

Contact Number: __________________________

__________________
Date