FM-

SWS-
09

STUDENTSWAI
VER

Dat
e:Febr
uar
y1,
2023
ThePr
esident
Thi
sColl
ege
Si
r:

Please bei nfor

medt hatIam permit
ti
ngMaryJaneB.Pelaezto
attendt heI NGRESS,EGRESS,ANDTHECONDUCTOF I CCATHLON 2023on
Febr uary4- 12,2023atMi ndor
oSt ateUni
ver
sit
y-CalapanCit
yCampus. I
assume f ullresponsi
bili
tyfor al l
owi
ng my son /daughter
/toj ointhe
aforement ionedacti
vit
y.

Ver
ytr
ulyy
our
s,

LETECI
AB.PELAEZ

FM-
SWS-
09

Dat
e:Febr
uar
y1,
2023

Towhom i tmayconcer n:
Thi
s is to cer t
if
yt hat I am v oluntari
ly joi
ning /par t
ici
pati
ng/
att
ending to/ t he I
NGRESS,EGRESS,ANDTHECONDUCTOF I CCATHLON
2023onFebr uar
y4- 12,2023,atMindor
oStateUni v
ersit
y-CalapanCityCampus.
Ialso declare thatnei t
herMinSUnorit
sof fi
cialsshoul
dbehel dresponsi
ble
foranyuntowardincidentthatmayhappendur ingtheacti
vity
.

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(
Student
’sSi
gnat
ure)
Not
ed: _
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__
Adv
iser

Acknowl
edged:
ALEXI
SP.FORTUNATO
Coor
dinat
or,
StudentAf
fai
rsandSer
vices