Parental/Guardian’s Consent
To Whom It May Concern:
I, , of legal age, Filipino, residentof
, and aparent/guardianof ,
a student of University of Cebu – LapuLapu and Mandaue, hereby freely voluntarily and knowingly give
my consent and assent for my child/ward to voluntarily and willfully join and participate in the-
, a university-relatedactivityon
at
.
IN WITNESS WHEREOF, I have hereunto affixed mysignaturethis dayof
, 20 , in the City of Mandaue,Philippines.
Printed Name & Signature of Parent/Guardian
With my conformity:
Printed Name & Signature of Student
UCLM/SFM-SAO-004-01