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Annex C: Parent'S/Guardian'S Consent Form

The document is a parent/guardian consent form for a learner to participate in an off-campus activity. It collects information about the learner and parent/guardian, and has the parent acknowledgement of risks and consent for the learner to participate in the activity.

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Maricar Magallanes
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90 views1 page

Annex C: Parent'S/Guardian'S Consent Form

The document is a parent/guardian consent form for a learner to participate in an off-campus activity. It collects information about the learner and parent/guardian, and has the parent acknowledgement of risks and consent for the learner to participate in the activity.

Uploaded by

Maricar Magallanes
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
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ANNEX C: PARENT'S/GUARDIAN’S CONSENT FORM

Name of Learner: ____________________________________________________________________


Date of Birth: ______________________________________________ Sex: _______________
Parent’s/Guardian’s Name: ____________________________________________________________
Relationship to Learner: _____________________________________________________________
Home Address: ___________________________________________________________________
Contact Number/s: ________________________________________________________________
Title of the Activity: ________________________________________________________________
Venue: ___________________________________________ Date of Activity: ________________

As the parent/ guardian of the abovementioned learner, I hereby


acknowledge that I have been informed of the details of the off-campus activity
and voluntarily and freely elect to participate in this off-campus activity.
Furthermore, I understand the risks associated with an off-campus activity and
agree that the rules and regulations established for the said activity are for the
safety and security of the participants, and thus agree to instruct my child or
children to obey them.

Having understood all the aforementioned, I hereby consent to allow my


child or children to participate, acknowledging all of the foregoing. I am also
solely responsible for providing travel insurance and any expenses for my child
or children's participation in the activity.

Parent/ Guardian's Name and Date


Signature

Notes (Other information you may wish to inform the teacher, such as child's medical condition,
etc):

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