ARELLANO UNIVERSITY

2600 Legarda St. Sampaloc, Manila

(TITLE OF ACTIVITY)
CONSENT FORM

I, ______________________, (parent/guardian) of ______________________ (student’s name), ___

years old, a student of Arellano University-Juan Sumulong Campus, do hereby give my consent,
willingly and voluntarily, for the participation of ____________ (student’s name), in the Virtual
Graduation 2021 to be shown online via Facebook on September 25, 2021 at 8:00 – 11:30 A.M.

By signing this consent form , I undertake to remind my son/daughter/ward to always act with due
diligence, safety, and care, endeavoring at all times to see to it that his/her conduct during the entire
affair/activity shall establish, maintain and contribute to his/her personal security and protection and
those of the other participants of the activity. By reason of said event, I understand and give consent
to personal information that may be shared to the public for legitimate purposes of the University. I
hold Arellano University, its officers, directors, personnel, free from any and all liability that may
arise from the participation of _______________________ (student’s name), in said event.

______________________
Parent/Guardian

Conforme:

______________________
Student

(Please attach copy of any valid ID of parent/guardian)