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    Parent Concent Form

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    francesannejaron19
    This document is a parent/guardian consent form from Laguna State Polytechnic University for a student to participate in an off-campus program. It has three parts where the parent gives permission for participation, authorizes emergency medical treatment if they cannot be reached, and agrees to waive liability for any injuries or damages that may occur from participation. The parent signs and dates each section, and the form is notarized.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Parent Concent Form

    Uploaded by

    francesannejaron19
    13 views1 page
    This document is a parent/guardian consent form from Laguna State Polytechnic University for a student to participate in an off-campus program. It has three parts where the parent gives permission for participation, authorizes emergency medical treatment if they cannot be reached, and agrees to waive liability for any injuries or damages that may occur from participation. The parent signs and dates each section, and the form is notarized.

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    Parent-Concent-Form

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    This document is a parent/guardian consent form from Laguna State Polytechnic University for a student to participate in an off-campus program. It has three parts where the parent gives permission for participation, authorizes emergency medical treatment if they cannot be reached, and agrees to waive liability for any injuries or damages that may occur from participation. The parent signs and dates each section, and the form is notarized.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    13 views1 page

    Parent Concent Form

    Uploaded by

    francesannejaron19
    This document is a parent/guardian consent form from Laguna State Polytechnic University for a student to participate in an off-campus program. It has three parts where the parent gives permission for participation, authorizes emergency medical treatment if they cannot be reached, and agrees to waive liability for any injuries or damages that may occur from participation. The parent signs and dates each section, and the form is notarized.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Republic of the Philippines

    Laguna State Polytechnic University


    Province of Laguna

    PARENT/GUARDIAN CONSENT FORM


    College:
    Campus: San Pablo City Campus

    Name of Student:

    Part 1. Permission to Participate


    I have understood the information concerning the _______________________ and give my son/daughter,
    _____________________________________ (name of student), permission to participate in the said program.
    I understand the arrangement for the mobility to the destination. I also understand that my son/daughter must
    meet the application requirements to be accepted in the program.

    ________________________________________ ________________________
    Signature of Parent/Guardian over printed name Date

    Part 2. Emergency Authorization


    In the event that I cannot be reached in an emergency, I give permission to the staff of LSPU or the staff of the
    off-campus activity office/unit/agency to secure proper treatment for my son/daughter.

    ________________________________________ ________________________
    Signature of Parent/Guardian over printed name Date

    Part 3. Liability
    I hereby agree to waive and release any and all rights that I, my child, or our representatives may have to make
    claim against LSPU of their respective officers, employees, or representatives arising from injury or damages,
    including attorney’s fees, that may result from my child’s participation in the off-campus activity.

    I further agree to indemnify and hold harmless the partner/cooperating office/unit/agency or their respective
    officers, employees, or representatives from any claims, including attorney’s fees, which I or my child might
    make or which might be made on my or our behalf by others, or which might be made against me or my child
    by others, arising from my child’s participation in the above-mentioned activity.

    ________________________________________ ________________________
    Signature of Parent/Guardian over printed name Date

    SUBSCRIBED AND SWORN TO before me, this ___ day of _____, 2023, exhibiting to me and was identified by me
    through his/her competent evidence of identity: _____________________________ issued on _____________
    at ____________________.

    ________________________
    Notary Public
    until _____________
    IBP No. ___________
    PTR No. ___________
    Doc No. ______
    Page No. ______
    Book No. ______
    Series of 20____

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