University

of Perpetual
HelpSystemLaguna
City of Biñ an, Laguna, Philippines, 4024
(+632)779-5310 • 544-5150 • 544-5161
www.uphsl.edu.ph

PARENTAL CONSENT FOR

LIMITED FACE-TO-FACE CLASSES

NAME OF STUDENT: JHANA MARIE T. ALLAPITAN

PROGRAM OF STUDY: BACHELOR OF SCIENCE IN ACCOUNTANCY

PARENT’S/GUARDIAN’S NAME: MARILYN T. ALLAPITAN

HOME ADDRESS: SANTA CATALINA, TUMAUINI, ISABELA

I, MARILYN T. ALLAPITAN, parent/guardian of JHANA MARIE T. ALLAPITAN, grant permission

for my child/ward to participate in face-to-face classes in core and professional courses.

As a parent/guardian, I am aware:

1. of the University of Perpetual Help System Laguna Policies, Procedures and Guidelines (PPG)
for limited face-to-face classes in core and professional courses;
2. that laboratory knowledge, methodologies are best acquired and simulated in the laboratory itself;
3. that University of Perpetual Help System Laguna has ensured that classrooms, laboratories and
other school facilities are retrofitted and that all their policies and procedures are in accordance
with CHED and IATF regulations as regards the emergence of diseases;
4. that University of Perpetual Help System Laguna has endeavored to ensure maintenance of a
healthy learning environment;
5. that I shall be one with the University of Perpetual Help System Laguna in monitoring my
child’s/ward’s academic progress and medical condition.

Finally, for any concern with my child/ward while in the University, I may be reached through this
contact number/email address: 0991-613-7667.

MARILYN T. ALLAPITAN
Signature over printed name of Parent/Guardian

* Please attach signed photocopy of a valid ID

SUBSCRIBED AND SWORN to before me this __26___ day of _AUGUST_____, in the

_________Tumauini, Isabela__________, Philippines, by the above-named Affiant who is identified by
me through a competent evidence of (his/her) identify. I further certify that the foregoing document was
signed in my presence and that I have personally examined the Affiant and I am convinced that (he/she)
understood (his/her) statements as (his/her) free act and voluntary deed
 UNIVERSITY OF PERPETUAL HELP SYSTEM LAGUNA- ISABELA
CAMPUS
Minante Uno, Cauayan City
COLLEGE OF BUSINESS AND ACCOUNTANCY

Republic of the Philippines)

______________________)
X-----------------x

AFFIDAVIT OF UNDERTAKING

I, MARILYN T. ALLAPITAN, of legal age, Filipino and a resident of SANTA

CATALINA, TUMAUINI, ISABELA, after having been duly sworn to in accordance with law, do hereby
declare and say:

1. That I am the parent/guardian of JHANA MAIE T. ALLAPITAN_

2. That my child, JHANA MARIE T. ALLAPITAN, is a 4TH YEAR - ACCOUNTANCY (year

level
& course) student of the University of Perpetual Help System Laguna for 1st semester, AY
20222023;

3. That the University has provided the option for my child to attend the LIMITED FACE-TO
FACE CLASSES which will begin on August 15, 2022 until end of the 1 st semester AY
20222023;

4. That I am allowing my child to participate in the LIMITED FACE-TO-FACE CLASSES;

5. That as the parent/guardian of JHANA MARIE T. ALLAPITAN, I am responsible for the

application and/or registration of my child for PhilHealth or any medical insurance covering
expenses for COVID-19 infections;

6. That I hereby undertake to shoulder the costs of hospitalization, medication and other expenses
related to the recovery of my child/ward in the event that he or she is infected by the virus thus,
exonerating the University of Perpetual Help System Laguna, the Members of the Board, and its
employees from any liability;

7. That I have read and understood the guidelines of the University for the conduct of the said
activity and I hereby undertake to follow the procedures necessary for my child to participate in
the LIMITED FACE-TO-FACE CLASSES;

8. That I am executing this affidavit in order to attest the truth of the foregoing for all legal intents
and purposes.

FURTHER AFFIANT SAYETH NAUGHT.

IN WITNESS WHEREOF, I have hereunto set my hand this 26TH day of AUGUST, in the
TUMAUINI, ISABELA, Philippines.

MARILYN T. ALLAPITAN
AFFILIANT

SUBSCRIBED AND SWORN to before me this _26____ day of _______AUGUST_____, in

the ______________________________, Philippines, by the above-named Affiant who is identified by
me through a competent evidence of (his/her) identify. I further certify that the foregoing document was
signed in my presence and that I have personally examined the Affiant and I am convinced that (he/she)
understood (his/her) statements as (his/her) free act and voluntary deed.

Doc. No.: ________:

Page No.: ________:
Book No.: ________:
Series of 2022

UNIVERSITY OF PERPETUAL HELP SYSTEM LAGUNA- ISABELA

CAMPUS
Minante Uno, Cauayan City
COLLEGE OF BUSINESS AND ACCOUNTANCY
Doc. No.: ________:
Page No.: ________:
Book No.: ________:
Series of 2022