The Thomas Aquinas Institute of Learning

Buhay na Tubig, imus City, Cavite

(046) 431 5228/ 09177183703

PARENTAL CONSENT AND WAIVER FORM

Our school will be having its annual Graduation and Completion Pictorial for Grade
10 and Grade 12 levels. In order to facilitate this activity safely, despite the pandemic, the
school will adhere to the health protocols and guidelines to ensure the health, safety, and
well-being of our students, staff, and teachers.
In consideration of being permitted to participate on the said pictorial activity, the
Parents/Guardians and Students hereby state and affirm to the following:
Policies and Guidelines for a Safe Graduation Pictorial

1. Students 15 years old and below should be accompanied by parent/guardian in the said
activity.

2. Wearing of facemask and face shield, and social distancing are strictly implemented inside
the school premises.
3. Strictly one (1) student is allowed every 30 minutes to enter the assigned room for
pictorial.
4. Follow the instructions given by the assigned teachers or person-in-charge for a smooth
undertaking of the activity.
5. Avoid social congregation before, during, and after the pictorial.
6. Each student who will participate in the activity will be given a scheduled day and time of
his/her pictorial upon submission of the waiver.
Moreover, by signing below, the Parent/Guardian and Student understand and
voluntarily agree that the student’s participation in the Completion/Graduation Pictorial shall
be at the Parents’ and Student’s sole risk, and that hereby voluntarily agree to waive and
discharge any and all claims against the School related to or arising out of COVID-19 or any
untoward incidents that may occur beyond the control of the School, and voluntarily release
the School from liability for any exposure to or illness or injury from COVID-19.
I hereby certify that I am the parent and/or legal guardian of the student below, that I
have read and understand the foregoing, and accept and agree to be bound by the terms and
conditions of the above, and hereby consent to allow my child to participate in the pictorial
activity.

Signature of Parent/Legal Guardian over Printed Name Date

Signature of Student over Printed Name Section/Strand

A dated and signed copy of this document must be submitted online to the class adviser until
May 27 (Thursday). Likewise, a printed copy must be submitted on the day of student’s
scheduled pictorial. NO WAIVER, NO PICTORIAL.