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Parental Consent

This document is a Parent/Guardian/Career Consent Form for students participating in Field Work/Immersion as part of their senior high school curriculum. It collects essential information about the student, parent/guardian, medical conditions, and consent for participation and travel. Parents/guardians must sign and return the form to the school to confirm their support and provide necessary details.

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Noelyn Flores
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12 views1 page

Parental Consent

This document is a Parent/Guardian/Career Consent Form for students participating in Field Work/Immersion as part of their senior high school curriculum. It collects essential information about the student, parent/guardian, medical conditions, and consent for participation and travel. Parents/guardians must sign and return the form to the school to confirm their support and provide necessary details.

Uploaded by

Noelyn Flores
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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SENIOR HIGH SCHOOL DEPARTMENT

PARENT/GUARDIAN/CAREER CONSENT FORM

Instruction: Please complete the following, sign and return to:.

Name of student: _____________________ Age: ____________

Name of Parent/Guardian: ________________________________

Address: ___________________________________
Mobile: ____________________________________

Family Doctor …………………………………………… Doctor’s Tel No:


…………………………........
Does your child suffer from any medical conditions/allergies that the teacher/ coach
should be aware of (including any current
medication) .........................................................................................................

………...…………………….
………………………………………………………………………………..……

Please provide details of medication that must be administered:

_____________________________________________________________________
Emergency contact details: (If different from above)

Name: ……………………………………………………………… Telephone no: ……………..


…………
Relationship to child:
……………………………………………………………………………….................

CONSENT (please read carefully)

a) I agree to my son/ daughter taking part in the Field Work/Immersion in partial


fulfilment of the Work Immersion to develop the independent and critical
skills of the students.
b) I confirm to the best of my knowledge that my son/ daughter does not suffer
from any medical condition other than those listed above.
c) I fully support the immersion undertaking of my son/daughter through
minimal financial cost and through my attendance/presence if so desired.
d) I consent to my son/ daughter travelling by any form of public transport,
minibus or motor vehicle by land in the course of gathering immersion.

Signed ………………………………….....................… (Parent/ Guardian)

Date: ……………………………

Victoria Bldg, Plaza Naning, Baliwag Bulacan (044-766-3040/ 0917-902-


0823)
aisatbaliuaginc@yahoo.com/ edz.bulos@yahoo.com

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