Form 2 SAO - PDF FINAL 1
Form 2 SAO - PDF FINAL 1
(General Meeting/Assembly)
SAO -F1
1. Requested by:
_______________________________
Club/Organization President
(Signature over printed name)
2. Recommended by:
_______________________________
Faculty Adviser
(Signature over printed name)
3. Consented to by:
__________________________
Coordinator, Academic Program
(Signature over printed name)
__________________________
Property Custodian
(Signature over printed name)
5. Approved by:
_______________________________
Coordinator, Student Affairs
(Signature over printed name)
6. Noted by:
_______________________________
Officer-In-Charge
(Signature Over Printed Name)
Note:
Please attach the following:
1. Letter of intent
2. Note of commitment (SAO-F2)
Submit this form with the attachments at least 3 working days before the activity. Once approved, copies of this form
will be furnished to the maintenance and security personnel.
In the name of Tagbilaran City College, I take full responsibility for this activity by attending to the students
and assure the Student Affairs Office that everything shall be taken care of.
______________________________________
Faculty-Adviser/or Designated Chaperon
(Signature over printed name)
*************************************************************************************
In the name of Tagbilaran City College, I take full responsibility for this activity by attending to
the students and assure the Student Affairs Office that everything shall be taken care of.
______________________________________
Faculty-Adviser/ or Designated Chaperon
(Signature over printed name)
09120397932 [email protected] https://www.facebook.com/iamtccsasofficial
OFFICE OF THE STUDENT AFFAIRS
(ACTIVITY PERMIT)
SAO-F3
Name of Organization/Class: __________________________________________________________________
Inclusive Dates/ and Time of Activity __________________________________________________________
Title/Theme: _________________________________________________________________________________
Venue: ______________________________________________________________________________________
Type of Activity: Please check appropriate box.
( ) Lecture ( ) Seminar-workshop
( ) Convention ( ) Film/Slide Showing
( ) Debate ( ) Hiking
( ) Outreach/Community Service/NSTP Off-Campus ( ) Beach Outing
( ) Immersion Program ( ) Recollection/Retreat
( ) Educational Tour/Field trip ( ) Plant/Campus Tour
( ) Drama/ Stage Play ( ) Induction Party/ Social Gathering
( ) Sports fest ( ) Evaluation/ Planning
( ) Mass/ Liturgical Service ( ) Youth Camp
( ) Others (Please specify) _____________________________________________________________
5. Noted by:
____________________________
Officer-In-Charge
Note:
For Outreach/Community Service/NSTP Off -Campus activities, the requesting party shall comply first the Community Extension/NSTP Office’s required
documents before securing the consent from the Coordinator of the Academic Program.
1. Please attach the following documents:
1. Letter of Intent specifying the rationale and objective/s of the activity.
2. Itinerary/ Program of Activities
3. Budget Proposal (if the activity needs budget)
4. Note of Commitment Legend: ** additional
5. List of Participants (if pre-determined) requirements for off-campus activities
6. Waiver (aged 18 and above) / Waiver and Informed consent (aged below 18)
7. Medical Certificate from the TCC Physician
8. Speaker/s Curriculum Vitae (for symposia, lecture, leadership training, seminar, etc.)
9. First Aid Kit Borrower Slip from the Health Services Office**
10. Proof of Insurance Provision **
11. Minutes and Attendance of the briefing/orientation **
12. Letter to parent/adults 1 month before the off-campus activity **
13. Emergency Preparedness Plan**
14. Mobility **
a. If Owned by HEI: Updated/valid documents pertaining to registration, insurance coverage, driver’s license
b. If Sub-contracting: LTFRB certificate for the validity of the franchise; updated/valid documents pertaining to registration, insurance
coverage, driver’s license
c. If Travel and Tour Operator: Accreditation Certificate by the DOT; same with a and b requirements.
I/We, the undersigned, hereby acknowledge that certain risks of injury are inherent in the participation in the aforementioned
activity/program. These types of injuries may be minor or serious.
I/We understand that, in case of emergency medical or hospital services being required by the above-listed participant, and with
the understanding that every reasonable effort will be made by the school/hospital to contact me, my signature on this form
authorizes the board, through its employees, agents, and officers, [to] secure such medical advice and services as they deem
necessary for my child’s health and safety, and that I shall be financially responsible for such advice and services.
I/We understand that the Rules and Regulations pertaining to this activity are designed for the safety and protection of
participants.
I/We acknowledge my right to obtain as much information as I require about this program or activity and associated risks and
hazards, including information beyond that provided to me by the school.
I/We acknowledge that it is my responsibility to advise the school of any medical and/or health concerns of my child that may
affect his/her participation in the stated program or activity.
I/We understand that the choice to participate brings with the individual the ASSUMPTION OF RISK which is part of those
activities.
I/We understand and agree that this is a part of the school program. I/We also understand that as a result of participating in this
program that the participant is expected to follow the school procedures and code of conduct and that any deviations from these
may result in consequences from the school administration.
I/We declare having read and understood the above INFORMED CONSENT AGREEMENT in its entirety and hereby consent to
participate being aware of all the foregoing.
Subscribed and sworn to before me this ____ day of ________________________ 20_____at Tagbilaran City.
The Officer-In-Charge
Tagbilaran City College
Tagbilaran City
Assumption of Risks:
By signing below, and in consideration for the opportunity to participate in the Activity, I voluntarily agree to
waive and discharge any and all claims including claims for negligent actions against the School, the management, the
representative, and the chaperon. By signing below, and in consideration for the opportunity to participate in the
Activity, I agree to release, discharge, and hold harmless the School, the management, the representative, and the
chaperon from all liability, claims, causes of action, or demands, including attorney fees, fines, fees, or other costs (e.g.
medical costs) arising out of any injury suffered from the activity.
___________________________________ _________________________
Student-Participant Date
___________________________________ _________________________
Witness Date
Subscribed and sworn to before me this ____ day of ________________________ 20_____at Tagbilaran City.