DON BOSCO SCHOOL (SALESIAN SISTERS), INC.

3500 V. Mapa Extension, Sta. Mesa, Manila, Philippines 1016

Telephone No. (632) 87147791 to 92
Telefax No. (632) 87147791 to 92 loc. 103
PAASCU Accredited / ESC-Certified

PARENT PERMISSION AND WAIVER FORM

ENGLISH MONTH CELEBRATION

ACADEMIC YEAR 2023-2024

I/We, the parents/guardians of the student named below, understand the nature of THE ENGLISH MONTH
CELEBRATION

We hereby grant permission for our son/daughter to participate. We understand that adequate and appropriate
health protocols and supervision will be provided. If an injury requires medical attention, I grant the supervising
teacher(s) permission to attend to my son/daughter. If the injury warrants further medical attention, I expect
every effort will be made to contact me to receive my specific authorization before action is taken. If efforts to
contact me are unsuccessful, I grant permission for necessary medical treatment to be given. In addition, I
hereby give my permission to the supervising teacher(s) to take my child to the physician, dentist, or to the
hospital if an accident or serious illness occurs on the trip and I cannot be located.

WAIVER
We recognize, however, that unanticipated situations and problems can arise during any school activities,
school-sponsored or otherwise, which situations or problems are not reasonably within the control of the
supervising teacher(s). As parents and guardians, we are voluntarily assuming all risks that notwithstanding the
school’s best efforts to implement and require compliance with prevention and mitigating measures of the Local
and National Government I, my family, together with my child, may be exposed to the Corona-Virus and may
become ill with COVID-19 or any of its mutations and such exposures and illness may result to personal injury,
temporary or permanent disability, or even death. We further agree to release and hold harmless the Don
Bosco School (Salesian Sisters), Inc. Board of Trustees, its agents, officers, and employees especially the
supervising teacher(s) of the said activity from any and all liability, claims, suits, demands, judgments, costs,
interest and expense, arising from such activities, including any accident or injury to the student and the costs
of medical services, or any cause beyond the control of DBS-Manila, including, but not limited to, natural
disasters, civil disturbances, acts of terrorism, and wars.

Date of Event: November 8-9, 13-14, 2023

Student Name: _____________________ Signature _______________ Date Signed: ________

Parent or Guardian: _________________ Signature ______________ Date Signed: ________
Home Phone: __________ Work Phone: __________ Cell Phone: __________
Mode of Transportation: _________________

If fetch, kindly indicate the fetcher name and contact number: _________________________________

MS. BABYLYN S. MONTEJO

English Coordinator

Approved by:

MR. JULES CESAR A SOTTO

Co-Curricular Coordinator

MRS. MARY GRACE C. MONTENEGRO

School Principal