A R E L L A N O U N I V E R S I T Y

OFFICE FOR STUDENT AFFAIRS

2600 Legarda St., Sampaloc, Manila

PARENT/GUARDIAN PERMISSION

Date: _______________________

To Whom It May Concern:

THIS IS TO AUTHORIZE AND GRANT PERMISSION to my son/daughter/dependent: MR./MS.

__________________________________________ , a __________________________(state course and
year/grade level and section) of Arellano University
_____________________________________________ (state the name of the
Department/School/Institute), to participate in chorale fest practice at Arellano University Jose Rizal
Campus on November 21, 28 and 29, 2003 from 12:35 pm to 3:00 pm (lunch time included)

I HEREBY CERTIFY THAT I have firmly advised 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.

I HEREBY HOLD THE UNIVERSITY, its officers, teachers, and advisers, free and harmless from any
and all claims caused by fortuitous events or other causes or factors beyond their control.

IN WITNESS WHEREOF, I have hereunto affixed my signature this _______ day of

____________________________at the City of _________________________.

______________________________
PARENT/GUARDIAN
(Signature over Printed Name)

SUBSCRIBE AND SWORN to before me this _____ day of _______________ in the City of Manila,
exhibiting to me his / her ____________________________________________________________.

Doc. No. ___________

Page No. ___________
Book No. __________
Series of __________