BED-SA-FO-020-(004)

St. Mary's Academy Basic Education Department JHS

Pasay City School Year 2023-2024
PERMISSION SLIP
Date: Click or tap here to enter text.
This is to inform you that your child:
Surname First Name: Click or tap here to enter text. Grade & Section: G8-PEACE
Is a representative of and/ or needed for (Please check one (1) only)
Academic Competitions Field Trip Conferences Retreat Recollection Youth Camp
✘ Non-Academic Competitions Seminars Trainings Community Involvement Practices
Name of the Activity: Click or tap here to enter text.
Venue ✘ inside SMA-P outside SMA-P: Click or tap here to enter text.
Date & Time Duration: September 1, 2023 and 2:30-
Supervising Teacher/s: Ms. De Castro
Materials Needed/ Attire: Click or tap here to enter text.
Noted by:
Principal /AC / STAC / GLC

PARENT GUARDIAN CONSENT

I (Name of parent/ guardian) Click or tap here to enter text. have read the above PERMISSION Slip.
✘ I'm ALLOWING my son/daughter to attend.
It is understood that the organizers will take necessary safety precautionary measures during the said
activity and, furthermore I release the St. Mary's Academy — Pasay City and the organizers from all liabilities for
injuries received/anything that could happen beyond their control during or resulting from participation in this
activity, %tetherit be during the activity or after the activity.
I DON'T ALLOW my child to attend. Reason/s Click or tap here to enter text.
Parent/Guardian Signature: Click or tap here to enter text.
Date: August 31, 2023________________________________Contact #: Click or tap here to enter text. _________