STA. LUCIA ACADEMY, INC.

Sta. Lucia, Ilocos Sur

October 27, 2023

Dear Parent/Guardian,

Greetings in the name of our Lord!

Our school is anchored with our core values Academic Excellence, Moral Formation and

Community Engagement. In connection to this, to intensify our community engagement for the holistic

development of our learners, we have chosen your son/daughter as one of our representative in the

upcoming cooking competition on October 28, 2023, 5 PM at Ban-aw Resort, Bagani Gabur,

Candon City, Ilocos Sur, sponsored by Sacred Heart Savings Cooperative Galimuyod Branch. The

expenses for the ingredients and other needs in the said competion will be provided by the school. Our

representatives will be accompanied by two teachers that will serve as their coach and mentor.

Attached with this letter is a copy of the parental consent and waiver.

Thank you very much and God bless!

Respectfully yours,

MICHAEL J. JIMENO

SHS Coordinator

Noted:

SAUL PYTHIAS F. CRISOLOGO

School Principal
 PARENTAL/ GUARDIAN CONSENT

Date:_________________
TO WHOM IT MAY CONCERN:

This is to certify that I allowed my son/ daughter ________________________________________________________________________

Name of Activity : ________________________________________________________________________________________________________

Name of Son/ Daughter : ________________________________________________________________________________________________
Date and Time : __________________________________________________________________________________________________________
Place/Venue : ______________________________________________________________________________________________________________

Thank you very much!

_____________________________
Parent/ Guardian
(Signature over Printed Name)

_____________________________________________________________________________________________________________________________

WAIVER

I, ____________________________________________________ presently enrolled in ___________________________________________

(Grade, Section,Track) present myself to participate in the ______________________________________________________________
_____________________________________________________________as representative of our school and do hereby pledge that:
1. I will obey and abide the rules and regulations promulgated, enforced by the school, carried by the
teacher-in-charge for the protection and safety of all;
2. I hereby waive and renounce my rights to all damages, hospitalization, and the like. I will not hold
the school, staff and the teacher concerned responsible for any misfortune, injury, or accident be
slight or serious, that may happen in connection with the activity. The cause of which will be
attributable to my acts of disobedience, negligence, and the offense of my heading to advice,
warning, precaution, and safety rules that were discussed to me the teacher-in-charge in joining the
activity.

The content of this waiver was read and explained to me before I affix my name and signature this ________th day of
_____________, 20___ freely and voluntarily.

_______________________________________________ _____________________________________________
Name of Student Name of Parent/ Guardian
(Signature over Printed Name) (Signature over Printed Name)