PARENT’S CONSENT FORM
I, ____________________, of legal age, the parent/guardian of _________________________,
and a resident of ______________________________________, solemnly swear and state the
following:
1. I hereby grant permission for my son/daughter to attend the program organized by the
Department of Energy Nuclear Coordinating Committee, entitled "Steering the
Academe Towards Careers in the Nuclear Industry," to be held at Sierra Hotel,
Dumaguete City, on May 28, 2025, from 8:00 AM to 5:00 PM.
2. In compliance with CHED Memorandum No. 63, I hereby declare that I am allowing
him/her to attend such activity, provided that the same is sanctioned by Negros Oriental
State University, and further provided that I am subsequently provided a Parent’s
Consent Form per activity, which need not be notarized.
3. I acknowledge that transportation will be provided by the university via a school bus
departing from the NORSU Main Campus I. I understand that my child may either use
the school bus or make his/her own arrangements to go directly to the event venue.
4. Liability Waiver: I hereby acknowledge and accept that if my child chooses not to use the
school bus and makes alternative travel arrangements, the school, its chaperones, and
employees shall not be held liable for any incidents, accidents, or situations that may
arise during travel or outside the organized activity. Any event occurring outside the
official activity, including travel to or from the venue not using the school bus, is solely
the responsibility of the parent/guardian.
5. I am executing this affidavit to attest to the veracity of the foregoing facts, in compliance
with the requirements of the Commission on Higher Education, and for whatever legal
purpose this may serve.
IN WITNESS WHEREOF, I have hereunto set my hand this _______________ at
_______________, Philippines.
______________________________
Signature over Printed Name
Gov’t ID ______________