UNIVERSITY OF THE EAST - CALOOCAN

College of Arts and Sciences

BASIC EDUCATION DEPARTMENT
STEM-Science and Engineering Strand

PARENTAL/LEGAL GUARDIAN
CONSENT FORM AND LIABILITY WAIVER

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As the parent or legal guardian of the child named below, I hereby give my full consent
and approval for my child to collect the necessary data for his/her research outside the
school premises. This activity is necessary to obtain the data needed for the
accomplishment of the research entitled “title here” which is integral for the completion
of the subjects HRE 121 – Research in Daily Life 2, HRE 122 – Research Project, and
HRE 123 – Research/Capstone Project.

To ensure the safety of my child, I commit myself to accompany him/her throughout

the data collection procedure/experimentation process. Furthermore, any activity
that requires my child to leave the premises of our home will be limited, thus, necessary
activities such as but not limited to buying of materials, gathering of samples, and
sending of samples to laboratories should be accomplished first via online means. In
case, where no online service is available, I will devote my time to personally assist the
needs of my child. I also promise that no other classes will be affected during the
conduct of this activity since this will only be scheduled before or after synchronous
sessions/school hours.

In addition to this, I do hereby waive, release, and hold harmless the university, its
officers, and teachers for any unexpected circumstances that may be encountered
during the conduct of this exercise.

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CHILD’S SIGNATURE OVER FULL NAME SECTION

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PARENT’S/GUARDIAN’S SIGNATURE CONTACT NUMBER
OVER FULL NAME