Emilio Aguinaldo College
OFFICE OF STUDENT AFFAIRS
PARENT’S CONSENT AND WAIVER FORM
Date Filed:
Month Day
Year
GENERAL INFORMATION OF ACTIVITY
SCHOOL/STUDENT ORGANIZATION
SPONSORING THE ACTIVITY NSTP Department
TYPE OF ACTIVITY (Please put a check mark on thexx Co-curricular (Student activities related to academic requirements)
type of activity that this waiver applies.)
xx Outside campus (Within NCR-CALABARZON
Area) Extra-curricular (Student activities not related to academic requirements)
Outside campus (Outside NCR-CALABARZON
Area)
Leadership Training Seminar
MODE OF TRANSPORT
Community Outreach Activities
Official School Transport xx Others:
Sports & Athletic Activities
Recreational Activities
Please specify ______Walking distance_____________.
Private Transport
Seminar/Conference/Convention
Volunteer Work
Rented Vehicle
Team Building
Competition/Contest
Commute via Public Utility Vehicle (Bus, Jeepney, Van, Train, Airplane, Ship and the
xx Others: like.)
Please specify__Community Immersion_________.
OBJECTIVES OF THE ACTIVITY
Inculcate ideas of patriotism and nationalism among the students, and enhance their involvement in public and civic-oriented activities.
AMOUNT OF FEES TO BE COLLECTED FROM
THE PARTICIPANT ₱ NO FEES TO BE COLLECTED
DATE OF THE ACTIVITY ADDRESS/VENUE OF THE ACTIVITY : (class date)
Barangay Hall, Barangay Burol Main, Dasmariñas Cavite
TIME AND PLACE OF DEPARTURE (class time) / EAC Lobby
TIME AND PLACE OF ARRIVAL (class time) / Barangay Hall, Barangay Burol
Main, Dasmariñas Cavite
FACULTY/ADVISER/SCHOOL OFFICIAL-IN-
CHARGE TO BE WITH THE STUDENTS FOR
THIS ACTIVITY (PROFESSOR)
NOTE:
1. Please fill up all the details requested. Incomplete forms will not be credited.
2. Write legibly in the spaces provided.
3. After accomplishing this form, please have it notarized in compliance with CMO Regional 190 Series of 2015.
4. Submit together with this form the photocopy of any government issued identification card of the parent/guardian
signatory.
5. Submit the completed form to the Office of Student Affairs a week before the scheduled activity.
QF-OSA-004 (06.16.2023) Rev.03
Emilio Aguinaldo College
OFFICE OF STUDENT AFFAIRS
PARENT’S CONSENT AND WAIVER FORM
CONTACT NUMBER OF PERSONNEL-IN-
CHARGE FOR THIS ACTIVITY
(Professor) – (Contact detail)
Date: __________________________
To the Office of Student Affairs,
As parent/guardian of ______________________________
Full Name of Student
_____________ _______________
ID Number
_______
Course & Year Level
Section
I voluntarily allow my son/daughter/ward to join and participate in the ___________________________________.
CWTS 2 - Community Immersion
Title of the Activity
Together with my child, I present this notarized document to personally express my willful understanding of
the terms and conditions stated in this form and that Emilio Aguinaldo College and its officers, faculty advisers and
staff are expected to observe legal diligence expected of them for the safety and security of my child for the entire
duration of the activity from departure and to the expected arrival.
This legal diligence would include oral and/or written instruction given to the student within the reasonable
time whether before or during the activity, that could ensure his/her safety and security.
In the event that my child disregards the instructions or acted on his/her own volition otherwise without
informing the personnel-in-charge I, as the parent/guardian shall therefore understand and shall have no claims
against Emilio Aguinaldo College, to the officers of the institution, faculty advisers and staff.
Respectfully Yours,
Printed Name of Guardian/Parent Signature Contact Details
Printed Name of Student Signature Contact Details
Schedule of Games
NOTE:
1. Please fill up all the details requested. Incomplete forms will not be credited.
2. Write legibly in the spaces provided.
3. After accomplishing this form, please have it notarized in compliance with CMO Regional 190 Series of 2015.
4. Submit together with this form the photocopy of any government issued identification card of the parent/guardian
signatory.
5. Submit the completed form to the Office of Student Affairs a week before the scheduled activity.
QF-OSA-004 (06.16.2023) Rev.03
Emilio Aguinaldo College
OFFICE OF STUDENT AFFAIRS
PARENT’S CONSENT AND WAIVER FORM
NOTE:
1. Please fill up all the details requested. Incomplete forms will not be credited.
2. Write legibly in the spaces provided.
3. After accomplishing this form, please have it notarized in compliance with CMO Regional 190 Series of 2015.
4. Submit together with this form the photocopy of any government issued identification card of the parent/guardian
signatory.
5. Submit the completed form to the Office of Student Affairs a week before the scheduled activity.
QF-OSA-004 (06.16.2023) Rev.03
