New Era University
No. 9 Central Ave., New Era, Quezon City
                                          ______________________________
                                                    Department
Date: __________________
Dear Sir / Madam:
The undersigned wishes to inform you that your child / ward __________________________________________
                                                                                      Name of Student
together with his / her classmates will undertake an off-campus activity on _______________________________
                                                                                                 Date
at _________________________________________________. The purpose of this activity is ______________
                       Location
__________________________________________________________________________________________
In view of this, we wish to obtain your consent for him / her to join this activity by signing the waiver below.
Thank you.
Truly yours,                                                                                  If dorm resident:
____________________________                               _______________________________
      Teacher / Instructor                                             SAO Director
_________________________________________________________________________________________
                                                        CONSENT
We / I, _________________________________________________________, parents/guardians of Elem. / High
                                  Name of parent/guardian
School / College student, _____________________________________, Year & Section ___________________
                                         Name of Student
Hereby affix our / my signature as a proof of our / my consent to our / my child’s joining the
____________________________________________ in ____________________________________________
                       Activity                                                       Location
We / I, hereby hold free and harmless New Era University, _________________________ and any of its officers,
                                                                        Department / Branch
Teachers and staff in the event of any accident, injury or sickness that may befall our / my child in the course of
this activity knowing that the school shall and will exercise extraordinary diligence.
Signed this _______ of _______________________, ________ in _____________________________________
               Day                       Month               Year                             Place
_________________                                                              _______________________________
       Relation                                                                       Signature over printed name
_________________________________________________________________________________________
                                                        CONSENT
We / I, _________________________________________________________, parents/guardians of Elem. / High
                                  Name of parent/guardian
School / College student, _____________________________________, Year & Section ___________________
                                         Name of Student
Hereby affix our / my signature as a proof of our / my consent to our / my child’s joining the
____________________________________________ in ____________________________________________
                       Activity                                                       Location
We / I, hereby hold free and harmless New Era University, _________________________ and any of its officers,
                                                                        Department / Branch
Teachers and staff in the event of any accident, injury or sickness that may befall our / my child in the course of
this activity knowing that the school shall and will exercise extraordinary diligence.
Signed this _______ of _______________________, ________ in _____________________________________
               Day                       Month               Year                             Place
_________________                                                              _______________________________
       Relation                                                                       Signature over printed name