PARENT’S CONSENT

I am allowing my son/daughter ________________________________, with ID number ______ to join and participate

in:

Sponsoring Unit: School of Liberal Arts

Title of Activity: Educational Field Trip
Date of Activity: May 2 and 3
Venue and address of the Activity: Manila and Laguna
Coordinator: Mr. Cyrus Maravilla and Ms. Judith Silang

Together with my child, I know that the organization and its officers, faculty, and staff are expected to exercise the due
diligence required for the health, safety, and well-being of my child during the activity on adhering date. The due
diligence includes oral and written instructions, given before or during the activity, that would ensure the safety of my
child.

In addition, I expressly undertake any risks and hazards involved with my child's participation in the activity, including but
not limited to those related to the COVID-19 or similar type virus. I realize that by participating in the activity, my child
may be exposed to faculty, staff, administrators, and other students and that he or she may get COVID-19, as well as
other viruses and diseases.

Further, I hereby authorize and give permission for faculty, staff, school physician, and administrators to ask general
questions related to COVID-19 symptoms and take appropriate actions in reporting any concerns, if necessary, prior to
this activity. That emergency medical treatment is to be rendered for any injury received while participating in any
supervised events. This authorization includes, but is not limited to, any treatment deemed necessary by certified
personnel, physicians, hospital emergency room physicians, and hospitals.

I certify that my child is in excellent health, does not have a fever, and does not have any current difficulties that would
make it unsafe for him or her to engage in an activity where a medical expert is not present. If my child has a fever or
illness or tests positive for COVID-19, I will notify the school and not send him/her to the activity.

If my child disregards or fails to follow instructions, including the safety and health protocols, or should act on his/her
own, I, together with my child shall have no claims against the institution, the organization, faculty, staff-in-charge of any
damage or liability to be sustained to any property or any person.

My signature below indicates that I have been given a copy of the DWCC Health and Safety Protocol/Guidelines, that I
have reviewed, and that I give permission for my child to participate.

IN WITNESS WHEREOF, I have set my hand and signature this _____ day of ________, 2024 at
___________________, Philippines.

SIGNED IN THE PRESENCE OF:

MS. MICHELLE B. LUZON BRO. HUBERTUS GURU, SVD, Ed. D

Student Affairs Office Director Vice President for Academic Affairs

__________________________________________________
Signature above Printed Name of Parent/Guardian Contact Number:

_________________________________________________
 PARENT’S CONSENT

REPUBLIC OF THE PHILIPPINES)

___________, ) s.s.

SUBSCRIBED AND SWORN to before me this _______ day of __________, 2024 at ______________________
Affiant having exhibited to me her/his government issued ID issued on _________________ at
_______________________________.

Doc. No. ____________;

Page No. ____________;
Book No. ____________;
Series of 2024