PARENT’S CONSENT
(for Full Face-to-Face RLE)
I, _________________________, Filipino, of legal age, with address at
_____________________________, after having been duly sworn to in accordance with law
hereby depose, state and undertake:
1) I am the parent/guardian of __________________________________, a ______ year student of
PHINMA-Cagayan de Oro College (COC) taking up ______________________.
2) The Commission on Higher Education (CHED) has approved for PHINMA-COC to conduct
full face-to-face classes relative to the subject ____________________.
3) I hereby affirm and confirm that I have been completely informed of the risks relative to the
full face-to-face classes of my son/daughter/ward in taking up the subject ______________
and I freely give my consent for my son/daughter/ward to take the said subject.
4) In view of the foregoing, I will not hold PHINMA-COC, its affiliate companies,
administrators, directors, officers, assigns, affiliates, employees and representatives,
LEGALLY RESPONSIBLE should my son/daughter/ward will be exposed to COVID19 and
all consequences and liabilities as a result of such exposure.
5) I hereby render free and harmless, PHINMA-COC its affiliate companies, administrators,
directors, officers, assigns, affiliates, employees and representatives, from any and all
LEGAL liabilities, claims, demands, actions, and causes of action, whatsoever arising out of
or by reason of my decision to allow my son/daughter/ward to enroll in
___________________.
6) In signing this document, I ACKNOWLEDGE AND REPRESENT that I have read this
document and the contents hereof, have understood it and signed it voluntarily as my own
free act and deed; no oral representations, statements, or inducements, apart from the
foregoing written agreement, have been made; and I execute this instrument fully intending
to be bound by the same;
IN WITNESS WHEREOF, I have hereunto affix my signature this ________________,
_____________, Philippines.
ID No. _________________
REPUBLIC OF THE PHILIPPINES)
MUN/CITY OF ___________________)S.S
COLLEGE OF ALLIED HEALTH SCIENCES
CAHS F2F Form 001
STATEMENT OF PARENTAL CONSENT
Dear Parents/Guardians:
Your child has expressed his/her intentions of joining the FACE TO FACE in his/her RELATED
LEARNING EXPERIENCE.
Title of Activity: FULL FACE-TO-FACE MODE OF LEARNING FOR STUDENT NURSES
to be held on at
(DATE OF ACTIVITY) (PLACE)
Should you have any questions please contact CAHS Office 09958457495.
………………………………………………………………………………………………….……….
Statement of Parental Consent
Please be informed that the undersigned poses no objection to the participation of my son/daughter,
______________________________________________________________________________
My son/daughter has expressed his/her intentions of joining the FULL FACE-TO-FACE activity to be
held in First Semester SY 2024-2025 at Affiliating Hospitals.
The PHINMA-COC will oversee the safety, behavior, and physical upkeep of your child but the
College and the accompanying adviser/s of the named student shall not be held liable for any accident,
untoward incident or damage that may be caused to said student, there being no fault or negligence on
the part of the College.
Signature over printed name of parent Contact # of Parent
I hereby state that the information above is true
Endorsed By: and correct.
Signature and Date
Name
Dean, College of Allied Health Sciences Organization
