PARENTS CONSENT FORM Fropm VPAA 02.15.2022

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PARENT’S CONSENT FORM1

This is to certify that I, _____________________________, am the parent/guardian


of _________________________________, a bonafide student of Romblon State University
(RSU), ________________________________________________________.

I further certify that I am allowing _____________________________ to go on an


internship for _____ weeks / _____ hours from ________________________ to
________________________ at ______________________________________________________ in
partial fulfilment of the requirements for the degree in
________________________________________________________. I understand the nature of
the internship and believe my son/daughter to be capable, qualified, in good health,
and in proper physical condition to participate in the Student Internship Program
(SIP).

I also allow my son/daughter to go on fieldwork if the job assigned requires


such.

It is understood that my son/daughter is obliged to follow the policies and


guidelines set by the school and abide by the rules and regulations that may be
imposed by the Host Training Establishment (HTE) for the welfare and safety of my
son/daughter. My son/daughter will be solely liable for any injury or damage arising
from his/her acts or omissions in the occasion of the internship. RSU will not be held
responsible nor pay any kind of compensation for any incident that my son/daughter
may cause during the internship.

I further fully understand that the organizers cannot be expected to control all
possible risks, but will act with diligence to ensure the safety and security of my
son/daughter as Student Intern. Hence, I will not hold RSU and the HTE responsible
for any untoward incident that may happen to my son/daughter in the duration of the
internship nor pay any compensation for such incident in spite of the best efforts of
RSU and HTE to ensure the safety and security of my son/daughter. I likewise release
RSU and the HTE from and against any and all loss, damage, costs, claims, and/or
causes of action arising out or related to the participation of my son/daughter in the
SIP.

I have fully read this Parent’s Consent Form and understood its terms. I signed
it voluntarily and with full knowledge this ____________________ in
_____________________.

________________________________________________ ________________________________
(Signature over printed name of parent/guardian (Relationship with the student)

Address:
____________________________________________________________________________
Contact No.: _______________________
ID Presented: _________________ Date Issued: ______________ Place Issued:
____________

Notary Public

1
This form must be accomplished in three copies and must be accompanied by a signed photocopy of a
valid government ID (e.g. Postal ID, Voter’s ID, GSIS ID, SSS ID, UMID, Philhealth ID, Senior Citizen ID,
Government Office ID, Driver’s License, Passport, and PRC ID).

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