CLARENDON COLLEGE

Roxas, Oriental Mindoro

Tel fax: (043)289-7056 / clarchsdept@gmail.com

Name of Student:
Grade Level – Section:
Class/Strand:

Name of School Club/Organization: Volleyball Club

Nature of Activity: PRACTICE
Venue: Clarendon College Date/Time: March 4, 2023, 8:00 am – 4:00 pm
Teacher – In – Charge of the activity: Gilbert E. Gonzales Contact number of teacher: 09453175953
To be filled by the Parent/Guardian:

I allow my son/daughter to attend the activity. I trust that the organizers of this activity will take due
diligence to ensure the safety of my son/daughter as a participant. I also agree to absolve the school
from legal responsibility on any untoward Incident In the course of the event.

I do not allow my son/daughter to attend the activity.

Name of Parent/Guardian and Signature: _________________________________________________
Contact Number of Parent/Guardian: ____________________________________________________

CLARENDON COLLEGE
Roxas, Oriental Mindoro
Tel fax: (043)289-7056 / clarchsdept@gmail.com

Name of Student:
Grade Level – Section:
Class/Strand:

Name of School Club/Organization: Volleyball Club

Nature of Activity: PRACTICE
Venue: Clarendon College Date/Time: March 4, 2023, 8:00 am – 4:00 pm
Teacher – In – Charge of the activity: Gilbert E. Gonzales Contact number of teacher: 09453175953
To be filled by the Parent/Guardian:

I allow my son/daughter to attend the activity. I trust that the organizers of this activity will take due
diligence to ensure the safety of my son/daughter as a participant. I also agree to absolve the school
from legal responsibility on any untoward Incident In the course of the event.

I do not allow my son/daughter to attend the activity.

Name of Parent/Guardian and Signature: _________________________________________________
Contact Number of Parent/Guardian: ____________________________________________________