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Parental Consent Form Template

This document is a parent/guardian consent form for a student at Tarlac State University to participate in an activity. It specifies that the student, with the given name and student number, has permission from their parent/guardian to join the named activity at the given venue and date. It notes that the student must abide by university and activity rules. The parent agrees not to hold the university responsible for any incidents. Space is provided for the parent/guardian and student signatures and for specifying whether consent is given or denied and the reason.

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Vine Macaraeg
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138 views1 page

Parental Consent Form Template

This document is a parent/guardian consent form for a student at Tarlac State University to participate in an activity. It specifies that the student, with the given name and student number, has permission from their parent/guardian to join the named activity at the given venue and date. It notes that the student must abide by university and activity rules. The parent agrees not to hold the university responsible for any incidents. Space is provided for the parent/guardian and student signatures and for specifying whether consent is given or denied and the reason.

Uploaded by

Vine Macaraeg
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

TARLAC STATE UNIVERSITY

STUDENT DEVELOPMENT UNIT


Romulo Blvd., San Vicente, Tarlac City 2300

PARENT’S/GUARDIAN’S CONSENT

______________
Date

TO WHOM IT MAY CONCERN:

This is to certify that I am allowing my son/daughter/ward ______________________________


(Student Name)

with Student Number: ________________ to join the _________________________________


(Name of activity)

at ___________________________ on ________________________. It is understood that my


(Venue) (Date)

son/daughter/ward shall abide by the rules and regulations that may be imposed by the

University and Faculty-in-charge for the welfare and safety of the group. It is further understood

that I fully agree to waive any responsibility on the part of the University/Faculty-in-charge in

case any untoward incident happens to my son/daughter/ward/ during the entire duration of the

event.

Signature of Parent/Guardian Signature of Student

I am allowing my son/daughter/ward to join the activity:


____________________________________________

I am not allowing my son/daughter/ward to join the activity because:


______________________________________________________________________
______________________________________________________________________

SUBSCRIBED AND SWORN to before me this ____________________ day of _____________,


_______, affiant exhibiting to me his/her Community Tax Certificate No. __________________ issued at
________________ on _________________.

WITNESS my hand and seal on the date and place first above-stated.

NOTARY PUBLIC
Until December 31, _____

Doc No. ………..


Page No ………..
Book No. ………..
Series of _______

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