Republic of the Philippines

Zamboanga Peninsula Region

Province of Zamboanga del Sur
ZAMBOANGA DEL SUR PROVINCIAL GOVERNMENT COLLEGE
Poblacion, Aurora, Zamboanga del Sur

COLLEGE OF AGRICULTURE/ BTVTED/ TVL-AFA

GUARDIAN/PARENTAL PERMIT

Type of Activity: LIVESTOCK OUTREACH PROGRAM

Venue:
Instructor/Adviser: AGGIE Faculty Organization: MAO-Aurora
Inclusive Date: Time In: 7:45 AM Time Out: 4:00 PM

Sir / Ma’am,
I hereby willingly and voluntarily consent to the participation of my son/daughter_____________
__________________________in the aforementioned activity. I have considered the benefits that he/she
will derive by participating in this undertaking. I understood that I will not hold any party responsible for
any untoward incidents which may happen in the course or duration of the activity as long as proper care
and due diligence are observe to ensure the safety and security of the student.

____________________________________ ______________
SIGNATURE OVER PRINTED NAME OF GUARDIAN DATE

STUDENTS CONTRACT
I AFFIRM THAT ALL INFORMATION CONTAINED HEREIN ARE TRUE AND CORRECT, THAT
I WILL NOT HOLD THE SCHOOL OR ANY INSTRUMENTALITY THEREOF RESPONSIBLE FOR
ANY UNTOWARD INCIDENTS THAT MAY HAPPEN DUE TO PERSONAL NEGLIGENCE,
IRRESPONSIBLE BEHAVIOR OR LACK OF ATTENTION THAT WILL CONSTITUTE VIOLATION
OF PRE-ARRANGED INSTRUCTIONS GIVEN TO ENSURE MY SAFETY AND SECURITY AND
THEREFORE BEYOND THE CONTROL OF DULY DESIGNATED PEER OF FACULTY/ADULT
MODERATORS. I ALSO UNDERSTAND THAT THIS ACTIVITY IS SANCTIONED AS AN
EXTENSION OF A SCHOOL UNDERTAKING AND THEREFORE ALL RULES AND POLICIES
PERTINENT TO SUCH ARE APPLICABLE AND IN FORCE.

CONFORME:
______________________________________ ________________

SIGNATURE OVER PRINTED NAME OF STUDENT DATE