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Guardian Consent Form for Student Activities

This document is a parental consent form for a student activity. It provides information about the type and dates of the activity, as well as the venue and time. The parent agrees to allow their son/daughter to participate and understands they are not responsible for any incidents as long as proper care is taken for student safety. The student also affirms the information is true and that they will follow instructions to ensure their safety during the activity. The document lists the faculty moderators accompanying the students. It reminds that students without consent cannot attend and must be notarized.

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Avery Jan Magabanua Silos
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69 views1 page

Guardian Consent Form for Student Activities

This document is a parental consent form for a student activity. It provides information about the type and dates of the activity, as well as the venue and time. The parent agrees to allow their son/daughter to participate and understands they are not responsible for any incidents as long as proper care is taken for student safety. The student also affirms the information is true and that they will follow instructions to ensure their safety during the activity. The document lists the faculty moderators accompanying the students. It reminds that students without consent cannot attend and must be notarized.

Uploaded by

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

OFFICE OF STUDENT AFFAIRS AND SERVICES

GUARDIAN/ PARENTAL CONSENT


OSAS-OC ____
Type of Activity: ____________________________ Venue:
___________________
Inclusive Dates: _____________________________ Time Finished:
______________

To: The Director of Student Welfare and Development

I hereby willingly and voluntarily consent to the participations of my


son/daughter ________________________________ in an aforementioned activity I have
considered the benefits that he/she will derive by participating in this undertaking. I understand
that I will not hold any party responsible for any untoward incidents which may happen in this
course of duration of the activity as long as proper care is observed to insure the safety and
security of the students.

_______________________________________ ______________________
(Printed Name and Signature of Guardian/Parent) Date

Address: ________________________________________
Contact Number(s)________________________________

STUDENT CONTACT

I affirm that all information contained herein are true and correct, that I will not
hold Southland College or any instrumentality thereof responsible for any untoward incidents
that may happen due to personal negligence, irresponsible behaviour, or lack of attention that
will constitute a violation of prearranged instructions given to insure my safety and security and
thereof beyond the control of duly designated peer or faculty/adult moderations. I also
understand that this activity is approved as an extension of undertaking and thereof all rules and
policies pertinent to are applicable.

CONFORMED:

_________________ __________________
_______________
Printed Name Signature Course

Faculty Moderator/s who will accompany the students in the said activity.
1. ____________________________
2. ____________________________

Important Reminders:
Student/s without Parent Consent cannot attend the activity mentioned above.

For strict compliance.

SUBSCRIBE AND SWORN to before me this _______________________day of


____________________________at _________________________________________
Negros. Occidental.

NOTARY PUBLIC
Doc. No. _________
Page No. _________
Book No. _________

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