STUDENT SERVICES AND DEVELOPMENT OFFICE

STUDENT’S WAIVER
Date: FEB. 23, 2024____
Dear Parent/Guardian:

Greetings from the Mountain Province State Polytechnic College.

This is to inform you that your child/ ward Neil Ford P. Dumanas, is one of the
students of Tala: The Mockingbird Student Publication who is qualified, and willing to go for
the Regional Schools Press Conference to attend at Tabuk City, Kaling on February 29- March
1, 2024. This activity aims to to provide a platform for student journalists to showcase their
skills, compete, and exchange ideas in various journalistic categories at a regional level.It also
provides a venue for the students to discover new knowledge and experiences.

Rest assured that your child/ward would be in safety as they would all be under the
direct supervision of Ms. Jenilyn T. Ana-as of the activity. Further, the College not shall not be
held responsible for any untoward incident that may occur outside/beyond the control of the
personnel-in-charge provided further that Precautionary measures and exhaustive efforts have
been taken by the instructor/employee in-charge.

Thank you for your support and cooperation.

Very truly yours,

JOSE N. CO
NOTARY PUBLIC
UNTIL , 20 JENILYN T. ANA-AS
PTR NO.: Instructor/Employee In-Charge Signature/
TIN: 183-340-302 Printed Name of Instructor

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PARENT’S/GUARDIAN’S CONSENT
To Whom It May Concern:

I, the undersigned parent guardian of Neil Ford P. Dumanas hereby voluntarily and
willingly allow and permit him/her to join the Regional Schools Press Conference to be
held on Feb. 29- March 1, 2024 at Tabuk City, Kalinga.

I am aware of the possible risks involved in the above-mentioned activity. For this
reason, I waive any or all actions/claims against the school or the personnel in-charge for any
untoward incident that may occur such as accidents and other fortuitous events provided that
precautionary measures and exhaustive efforts have been taken by the instructor/employee in-
charge.

Done this 23rd day of February, 2024at Bontoc, Mountain Province, Philippines.

LOURDES C. PAYAGEN
Signature/Printed Name of Parent/Guardian

CERTIFICATION

I, hereby certify that my parent/ guardian granted permission for my participation on

the above mentioned activity. This is manifested by his/her signature above.

JOSE N. CO
NOTARY PUBLIC
UNTIL , 20 NEIL FORD P. DUMANAS

PTR NO.: Signature over Printed Name of a Student

TIN: 183-340-302
MPSPC-SSD-F-008/02/September 4, 2023
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