PARENT/GUARDIAN CONSENT AND WAIVER

I, ______________________________, the parent/ guardian of

_________________________, require our child/ward to go out from the school
campus during lunch break for ________________________________________
__ __ _ __ _
________________________________________________________________.

As the parent/guardian, we are held responsible for any untoward incident

that may happen to my child/ward outside the school campus during lunch break
and that the school and its personnel is not liable of any responsibility while my
child/ward is outside the school.

This is in support for my child/ward to be given gate pass during lunch

break.

________________________
Name of Parent and Signature

Noted:

_________________________
Name of Adviser and Signature