Scribd
Upload
407 views1 page

Parental Consent and Waiver Form

This parental consent and waiver form provides information about a student participating in an activity and gets permission from their parent or guardian. It includes the student's name, age, school and emergency contact. The parent gives permission for their child to participate and acknowledges the benefits, while releasing the school from responsibility for incidents beyond their control. Both the parent and student sign and date the form, which is then verified by the school head.

Uploaded by

ErEr Uno Rosil
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
407 views1 page

Parental Consent and Waiver Form

This parental consent and waiver form provides information about a student participating in an activity and gets permission from their parent or guardian. It includes the student's name, age, school and emergency contact. The parent gives permission for their child to participate and acknowledges the benefits, while releasing the school from responsibility for incidents beyond their control. Both the parent and student sign and date the form, which is then verified by the school head.

Uploaded by

ErEr Uno Rosil
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 1

PARENTAL CONSENT AND WAIVER FORM

STUDENTS PERSONAL INFORMATION:

Name: ____________________________ Age: ____ Birthday: ____________________


Grade Level: _____________ School: ____________________ Organization Representing: ______________
Address: _______________________ Contact Number: ________________ Email address: _________________
Contact person in case of emergency: ______________________________ Relationship: __________________
Contact Number: ________________

The undersigned hereby given permission to__________________________________________________


(name of child)

a Grade ______ student of ___________________________ to participate in the ___________________________


(level) (name of school) ( name of activity)

I hereby authorized an adult in the person of the assigned District SPG/SSG Coordinator to assist and accompany my child in
participating in the said activity.

I have considered the benefits that my son/daughter will derive from his/her participation in this activity provided that the
due care and precaution will be observed to ensure the comfort and safety of my son/daughter and that DepEd employees
and personnel may not be held responsible for any untoward incident that may happen beyond their control.

_________________________________ ____________________________________
Signature over Printed Name ( Parent/Guardian ) Signature over Printed Name ( Student Participant )

________
Date Signed

Verified by:

_________________________________
Signature over Printed Name ( School Head )

You might also like