PHILIPPINE ASSOCIATION OF STUDENTS IN

OFFICE ADMINISTRATION
CAMARINES SUR POLYTECHNIC COLLEGES CHAPTER
College of Tourism, Hospitality, and Business Management

PARENTS’/GUARDIANS’ PERMIT FORM

TO WHOM IT MAY CONCERN,

This certifies that , a________
student of the college of ____________ with Student
No. _________________has the permission of his/her undersigned parent(s)/guardian(s)
to participate and/or attend in the _______________________
on ______________ _____, 20 in .

This certifies further that the risk assessment plans necessary safety and
precautionary measures have been instituted.
Further, that the following faculty members shall accompany him/her in the activity.

1. ________________________ ____________________
Faculty Name Signature

2. ________________________ ____________________
Faculty Name Signature

3. ________________________ ____________________
Faculty Name Signature

I/We have honestly and accurately completed all parts of the Parents’/Guardians’
Permit Form to the best of my/our ability. I/We fully agree to waive any responsibility on
the part of PASOA – CSPC Chapter, and the faculty-in-charge in case of any untoward
incident that may happen to _________________ in the duration of the Regional
Congress.
_______________________________ ______________________________
Parent/Guardian Name and Signature Date Parent/Guardian Name and Signature Date

__________________________ _________________________
Complete Address Complete Address

Emergency Contact Details:

Parent’s Mobile Phone No. : __________________________

Emergency Contact No. (1): __________________________
Emergency Contact No. (2): __________________________

Effectivity Date: August 2022 Rev. No. 1 Page 1 of 1