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Notarize Paper

This document is a certification allowing a student from Riverside College to attend a clinical exposure outside Riverside Medical Center as part of their learning experience. The parent acknowledges that they will not hold the college or its representatives liable for any incidents that may occur. The document includes sections for student and parent signatures, personal information, and a notary section.

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John Betita
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20 views2 pages

Notarize Paper

This document is a certification allowing a student from Riverside College to attend a clinical exposure outside Riverside Medical Center as part of their learning experience. The parent acknowledges that they will not hold the college or its representatives liable for any incidents that may occur. The document includes sections for student and parent signatures, personal information, and a notary section.

Uploaded by

John Betita
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

www.riverside.edu.

ph

Date: _________________

TO WHOM IT MAY CONCERN:

This is to certify that with the knowledge of particulars herein set forth, I am allowing
my son/daughter, a student at Riverside College, to attend the scheduled clinical area of
exposure outside Riverside Medical Center Inc. as part of their RELATED LEARNING
EXPERIENCE. ( Please fill up the information below).

NAME: ________________________________ AGE:_______________

COURSE, YEAR and SECTION: ___________ ID. NO._____________

I will not hold Riverside College or any of its representatives liable for all untoward
incidents that may happen beyond their control or knowledge in connection with the
specified activity.

__________________________________ __________________________________
Student signature over printed name Parent signature over printed name

Address:_________________________ Address:__________________________
Contact No:______________________ Contact No:_______________________

Subscribed and sworn to before me this___________ day of _____________________, 2025 at


________________________. Affiant exhibiting to me his/her ______________ I.D. No.________

DOC NO. ___________


PAGE NO.___________
BOOK NO:__________
SERIES OF__________

Dr. Pablo O. Torre Street, Capitol Subdivision, Brgy 5. Bacolod City, Philippines, 6100

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