Annex C: Parent'S/ Guardian'S Consent Form

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Annex C: PARENT’S/ GUARDIAN’S CONSENT FORM

Name of Learner: ____________________________________________________________

Date of Birth: _____________________________ Sex: __________________________

Parent’s/ Guardian’s Name: ____________________________________________________

Relationship to Learner: ______________________________________________________

Home Address: _____________________________________________________________


Contact Number/s: __________________________________________________________

Title of the Activity: __________________________________________________________

Venue:________________________________________ Date of Activity: _______________

As the parent/ guardian of the above mentioned learner, I hereby acknowledge that I
have been informed of the details of the off- campus activity and voluntarily and freely elect to
participate in this off- campus activity. Furthermore, I understand the risks associated with an
off- campus activity and agree that the rules and regulations established for the said activity are
for the safety and security of the participants, and thus agree to instruct my child or children to
obey them.
Having understood all the aforementioned, I hereby consent to allow my child or
children to participate, acknowledging all of the foregoing. I am also solely responsible for
providing travel insurance and any expenses for my child or children’s participation in the
activity.

_____________________________________ _________________
Parent/ Guardian’s Name and Signature Date

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