Republic of the Philippines

SURIGAO DEL NORTE STATE UNIVERSITY

Narciso Street, Surigao City 8400, Philippines

“For Nation’s Greater

Heights”

PARENT’S CONSENT

 I    ___________________, and     _________ _____, parent/guardian of

__ ________________________, a student of Surigao del Norte State University,
City Campus, Surigao City have hereunto grant permission for him/her to participate
in the Community Immersion activity for CWTS- National Service Training Program
at  Brgy. San Roque, Surigao City on four consecutive Saturdays; February 25, 4,
11, and March 4, 20223. 

It is fully known that I have read and understood the entirety of the parent's
consent, and that I have signed it with our voluntary act and deed. Furthermore, the
organizers of this event will not be held liable for any untoward incident that occurs
outside of the activity, including before and after the aforementioned event.

Signed this ___ day of ________ , 2023 in the City of Surigao, Philippines.

____________________________ ___________________________
Signature of father / Guardian Signature of mother / Guardian

CONFORME:
______________________________
Signature of Student

Tel. Nos.: (086) 827-3741 Email: info@snsu.edu.ph

(086) 827-3742 URL: snsu.edu.ph