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Flores Registration Form Final

The document is a registration form and waiver for a Flores de Mayo event at Our Lady of Miraculous Medal Chapel in Iloilo City, Philippines from May 1-31. It requests the registrant's name, sex, age, grade level, school, and parent's contact information. The parent must sign a waiver agreeing for their son/daughter to participate from 2 PM daily, abide by event rules, and waive responsibility of the chapel if any incidents occur.

Uploaded by

Joven Apistar Lastiere
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© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
150 views

Flores Registration Form Final

The document is a registration form and waiver for a Flores de Mayo event at Our Lady of Miraculous Medal Chapel in Iloilo City, Philippines from May 1-31. It requests the registrant's name, sex, age, grade level, school, and parent's contact information. The parent must sign a waiver agreeing for their son/daughter to participate from 2 PM daily, abide by event rules, and waive responsibility of the chapel if any incidents occur.

Uploaded by

Joven Apistar Lastiere
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Our Lady of Miraculous Medal Chapel

West Visayas State University Medical Center


Jaro, Iloilo City, Philippines 5000
Flores de Mayo Registration Form

Name: _________________________________________________ Sex: M F

Age : ____________ Grade Level : ______________ School : ________________________

Parent’s/ Guardian’s Name : ______________________ Contact Number: ______________


___________________________________________________________________________

Waiver

This is to certify that I am allowing my son/daughter to join the Flores de Mayo from May 1- 31 from
Monday to Saturday every 2 PM . It is understood that my son/daughter shall abide by the rules and
regulations that may be imposed by Our Lady of Miraculous Medal Chapel for the welfare and safety of
the group. It is further understood that I fully agree to waive any responsibility on the part of the Chapel
and personnel-in-charge in case any untoward incident happens to my son/daughter during the entire
duration of this activity.

___________________________________

Parent’s/ Guardian’s signature over printed name

Our Lady of Miraculous Medal Chapel


West Visayas State University Medical Center
Jaro, Iloilo City, Philippines 5000
Flores de Mayo Registration Form

Name: _________________________________________________ Sex: M F

Age : ____________ Grade Level : ______________ School : ________________________

Parent’s/ Guardian’s Name : ______________________ Contact Number: ______________


___________________________________________________________________________

Waiver

This is to certify that I am allowing my son/daughter to join the Flores de Mayo from May 1- 31 from
Monday to Saturday every 2 PM . It is understood that my son/daughter shall abide by the rules and
regulations that may be imposed by Our Lady of Miraculous Medal Chapel for the welfare and safety of
the group. It is further understood that I fully agree to waive any responsibility on the part of the Chapel
and personnel-in-charge in case any untoward incident happens to my son/daughter during the entire
duration of this activity.

___________________________________

Parent’s/ Guardian’s signature over printed name

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