Republic of the Philippines

CEBU TECHNOLOGICAL UNIVERSITY

SAN FRANCISCO CAMPUS
Northern Poblacion, San Francisco, Cebu, Philippines
Website: http://www.ctu.edu.ph E-mail: cultureandarts.sanfran@ctu.edu.ph
Phone: +6332 402 4060 loc. 1137

COLLEGE OF ARTS & SCIENCES

____________________________________________________________________________

PARENT’S CONSENT

I/We, GENEROSA C. MONTALBAN parents/guardian of RODEL F. CHUA, a student of Cebu

Technological University-San Francisco Campus have here unto grant permission for my son/daughter to
join/participate Inter-Class Tournament as Final Exam in Path-Fit 4 on ______________ at Cebu Technological
University San Francisco Campus Cebu

That we made it known our continued moral support to him/her during the said event. That we shall
adhere to any disciplinary action of the school.

That whatever they have rehearsals outside the campus, I’m allowing my son/daughter to join in the
presence of their coaches following local health IATF protocols.

_GENEROSA MONTALBAN_
Signature of Parent(s)/Guardian

WAIVER

THIS IS TO CERTIFY that the CEBU TECHNOLOGICAL UNIVERSITY-San Francisco Campus is in no

way responsible nor shall pay compensation for any accident, harm, or injury that may be caused to our
son/daughter during the event, provided to follow health protocols and preventive measures are being
implemented to prevent any spread, infection, and accident to happen.
It is fully known that we have read and understood all the contents of the parent’s consent and
waiver and have signed the same with our voluntary act and deed.

Signed this _16_day of May 2023 in San Francisco Cebu, Philippines.

GENEROSA MONTALBAN_
Signature of Parent(s)/Guardian

CONFORME: RODEL F. CHUA

Name & Signature of the Student

WITNESS:

SZARAH V. SAMPAN, MAT-PE

Path-Fit 4 Instructor

Recommending approval:

ISRAELI S. CAMINOS, Ed. D

Director, College of Arts & Sciences

SUBSCRIBED AND SWORN TO before me this 16 day of May 2023 at San Francisco Cebu,
Philippines.

JONITA V. LITERATUS, Ph.D,-TM

Campus Director