REPUBLIC OF THE PHILIPPINES )

PROVINCE OF SULTAN KUDARAT) S.S.

CITY OF TACURONG )
x-----------------------------------------------x

AFFIDAVIT OF CONSENT

I, MELEN E. LIBRETA, of legal age, Filipino, married and a resident of Raja

Muda, Tacurong City, Sultan Kudarat, Philippines, having been duly sworn to in
accordance with law, do hereby depose and say:

1. That I am the parent/guardian of EZEL KAYE E. LIBRETA , a bona fide 3rd

year BS in Computer Engineering student of Sultan Kudarat State University
(SKSU), Isulan Campus, Capitol Centro, Kalawag 2, Isulan, Sultan Kudarat;

2.That I gave consent to EZEL KAYE E. LIBRETA to travel to Koronadal City,

South Cotabato on September 14-15 to attend the ICpEP.se Internaional
Convention.

3. That I understand that EZEL KAYE E. LIBRETA will be guided by the

University rules on student conduct as specified in the University Student
Handbook as well as in compliance with the revised policies, standards and
guidelines on Student Learning/Educational Tour and per CMO No. 17, Series of
2012;

4. That I understand that under the CMO No. 17, Series of 2012, before the
educational tour/field trip, the University or duly authorized representative/faculty
concern shall conduct briefing on the precautionary measures and risk
assessment procedures. Should there be any untoward incident that would
happen beyond human control, the University will not assume full responsibility
over the students while having their Learning/Educational Tour;

5. That I give my consent, full financial support and have no objection for the said
travel of EZEL KAYE E. LIBRETA;

6. That I execute this Affidavit of Consent to attest the above-facts and for
whatever legal purpose it may serve best;

IN WITNESS WHEREOF, I have hereunto set my hands this ____ day of

September 2023 at _________________, Sultan Kudarat.

_______________________________
(Signature over Printed Name of Affiant)

SUBSCRIBED AND SWORN to before me this ____ day of September 2023 at

________________, Sultan Kudarat, affiant exhibiting to me his/her Identification card
bearing No. _____________ wherein his/her picture appears as proof of his/her identity.
I further certify that he/she voluntarily executed his/her statement, explained to him/her
its contents and signed and affirmed the same under oath.

_______________________________
Notary Public

Doc. No. _______;

Page No. _______;
Book No. _______;
Series of 2016