Republic of the Philippines

UNIVERSITY OF RIZAL SYSTEM

Province of Rizal

Office of Student Development Services

Student Organization Unit
T. Reyes st. San Jose Montalban, Rizal / ursrodriguezregistrar@gmail.com / (02) 85399945 (02) 85399947

PARENTAL CONSENT FOR STUDENT ACTIVITIES

I hereby willingly and voluntarily give consent to Nicole A. Fuentes

(NAME OF STUDENT)

To participate in the Acquaintance Party to be held University of the Rizal System Rodriguez
(EVENT) (PLACE OF EVENT)

October 27, 2023

(DATE OF EVENT)

I have considered the benefits that my child will derive from participating in
this activity, with the understanding that due care and precaution will be observed to
ensure the comfort and safety of the delegates/participants to this activity and that I
shall not hold the parties responsible for any untoward incident that may happen
beyond their control.

Conforme:

Nita A. Fuentes Nicole A. Fuentes

(Signature over Printed Name) (Signature over Printed Name)
Parent/Guardian Student

Recommending Approval:

DR. STEPHEN P. SOLIGUEN PROF. MARIA RIZA A. ADOLFO

Dean, College of Education Coordinator, SDS

Approved:
DR. FLORANTE J. MERCADO
Director, Rodriguez Campus