ARELLANO UNIVERSITY 2600

Legarda St. Sampaloc, Manila

CONSENT FORM
SCHOOL YEAR 2022-2023

I, Ma. Christina N. Bolina, (parent/guardian) of Pauline N. Bolina (student’s name), 17

years old, a student of Arellano University- Andres Bonifacio (campus), do hereby give
my consent, willingly and voluntarily, for the participation of Pauline N. Bolina (student’s
name), in all official school activities approved by respective authorities within the school
to be shown and/or posted online.

By signing this consent form, I undertake to remind my son/daughter/ward to always act

with due diligence, safety, and care, endeavoring at all times to see to it that his/her
conduct during the entire affair/activity shall establish, maintain and contribute to his/her
personal security and protection and those of the other participants of the activity. By
reason of said event, I understand and give consent to personal information that may be
shared to the public for legitimate purposes of the University. I hold Arellano University,
its officers, directors, personnel, free from any and all liability that may arise from the
participation of Pauline N. Bolina (student’s name), in said events.

Ma. Christina N. Bolina

Parent/Guardian

Conforme:

Pauline N. Bolina
Student

(Please attach copy of any valid ID of parent/guardian)