Plaza A. Hernandez, 1202 Ilaya St.
Tondo, Manila, 1012
PAASCU ACCREDITED LEVEL I
Center for Christian Formation Office
WAIVER FORM FOR STUDENTS DURING ONSITE CAMPUS ACTIVITY
Date: _________________________
Dear Sir/Madam:
As parent/guardian of ________________________________________________ of
Grade ______ - St. __________________________, I allow my son/daughter to join and participate in:
Department/ Sponsoring Activity: Center for Christian Formation Office
Nature of Activity: Sunday Family Mass Devotion
Place of Activity: Archdiocesan Shrine of Sto. Niño de Tondo
Date and Time of Activity: I 9:30 AM – 11:00 AM
Staff-in- charge: Mr. Rogene A. Pangan and Mr. Andrew Joseph S. Manalo
Attire: Complete School Uniform
Pick up point: HCCS Gate 2
Drop off point: HCCS Gate 2
Together with my child, I know that the School and its officers, faculty and staff are expected to exercise the legal diligence
required for the safety and well-being of my child for the duration and the place, date and time of the activity as stated.
This legal diligence would include oral or written instructions, whether given before or during the activity, that if followed,
would ensure the safety of my child. For that reason, I had meticulously reminded my child to follow all these school
instructions for his/her safety during the entire on/off-campus activity.
If my child disregards or fails to follow those instructions or should act on his/her own, I, together with my child, shall have
no claim against the School, its officers, administrators, teachers, adviser, staff-in- charge should any damage be caused,
or liability be incurred to property or person.
Very truly yours, Noted by:
-signed-
____________________________________________ MR. ROGENE A. PANGAN
PRINTED NAME & SIGNATURE OF PARENTS/GUARDIAN Center for Christian Formation Officer
CONTACT NUMBER/S: ______________________ MS. MA. FRANCELA FRANCO
Student Activities Coordinator
___________________________________________
PRINTED NAME & SIGNATURE OF STUDENT Approved by:
MS. JENNY LYN CHUA
Assistant School Principal
