CARITAS DON BOSCO SCHOOL

Laguna Blvd., Laguna Technopark, Brgy. Biñan, Biñan, Laguna 4024

Mailing Address: P.O. Box 39935, LTI Post Office, Sta. Rosa, Laguna 4026
Tel. No. 0949-8611270/0917-6234841

PARENT/GUARDIAN WAIVER/CONSENT FORM

COVID-19 is a highly contagious respiratory virus that affects people of all ages and people from
all walks of life. The school will implement the minimum public health standards set by the
government to ensure an environment conducive to learning.

I understand that my child/dren attendance in school is completely voluntary and assume that
there is still risk of possible COVID-19 transmission.

With full understanding, I consent my child to attend the face-to-face learning modality.
However, I will not allow my child/ren to physically attend classes if my child/dren or any member
of the household develops sign and symptoms may or may not related to COVID-19 include but
are not limited to fever or chills, cough, shortness of breath, fatigue, muscle and body aches,
headaches, loss of taste or smell, sore throat, congestion or runny nose, nausea, vomiting, and
diarrhea.

We will follow the required health and safety protocols and procedures adopted by the schools.

I ___________________________ father/mother/guardian of ________________________ give

my full consent and allow him/her to attend the face to face class at Caritas Don Bosco School
for this SY 2022-2023.

I understand that being unvaccinated, I am aware and responsible that my child/ren is at

higher risk for contracting COVOD-19 and therefore accept any consequence it may result
to the health of my child.

I understand that being vaccinated, there are still certain risks that my child can acquire
and therefore accept the consequence it may result to the health of my child.

Furthermore, I do hereby agree that I will not hold Caritas Don Bosco School its officers and
employees liable for any aftereffect it may cause to the well-being my child.

______________________________
Signature over Printed name

Date: _________________________
Contact No. ____________________