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Parent's Activity Waiver Form

This document is a parent's permit and liability waiver form for a student to participate in an activity outside of school. It requests permission for a specific student to participate in a named activity at a given place and time. It also waives the school's liability for any incidents that may occur to the student during the activity beyond the school's control. The parent signs to acknowledge considering the benefits and experiences for their child and releasing the school from liability. Space is also provided for notarization if the activity is outside the local region.

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Jessa Molines
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142 views1 page

Parent's Activity Waiver Form

This document is a parent's permit and liability waiver form for a student to participate in an activity outside of school. It requests permission for a specific student to participate in a named activity at a given place and time. It also waives the school's liability for any incidents that may occur to the student during the activity beyond the school's control. The parent signs to acknowledge considering the benefits and experiences for their child and releasing the school from liability. Space is also provided for notarization if the activity is outside the local region.

Uploaded by

Jessa Molines
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
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Document No.

WVSU-OSA-SOI-02-F02
PARENT’S PERMIT AND LIABILITY
Issue No. 1
WAIVER
Revision No. 0
Date of Effectivity: July 24,2018
WEST VISAYAS STATE UNIVERSITY Issued by: OSA
Page No. Page 1 of 1

(Address )

(Tel. No. )

(Date)

(Name of Faculty In-Charge)

(Section/Name of Student Organization)

Sir/Madam:

The undersigned request that


(Name of Student)
be allowed to participate in
(Activity)
which shall be held at
(Place/Venue)
on (date) at (time)
I have considered the benefits that my son/daughter may derive from his/her participation and/or the
experriences that he/she may gain from the activity, and that the school will not be liable for any untoward
incident that may happen to the student beyond their control during the duration of the activity.

(Signature of Parent/Guardian over printed name)


Note: for travels outside Western Visayas/ Educational Tours

REPUBLIC OF THE PHILIPPINES


( S.S)
BEFORE ME, Notary Public for and in the city and Province of NEGROS OCCIDENTAL, this ___ __
at personally appeared with CTC No. ____

Known to me to be the same person who executed the forgoing instrument and they acknowledge
that the same in their free and voluntary act and deed.

WITNESS MY HAND AND SEAL


Notary Public
Doc. No.
Page No.
Book No.
Series of

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