Scribd
Upload
6 views

OSA-PARENT-CONSENT (1)

The document is a Parental Guardian Permit Form for off-campus activities at Wesleyan University Philippines, requiring details about the student, activity, and responsible faculty/staff. It outlines the responsibilities of the parent/guardian regarding the safety of the student and the non-compulsory nature of the activity. The form also includes a section for the parent/guardian and student signatures, affirming their understanding of the terms and conditions.

Uploaded by

Edwin Antonio
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
6 views

OSA-PARENT-CONSENT (1)

The document is a Parental Guardian Permit Form for off-campus activities at Wesleyan University Philippines, requiring details about the student, activity, and responsible faculty/staff. It outlines the responsibilities of the parent/guardian regarding the safety of the student and the non-compulsory nature of the activity. The form also includes a section for the parent/guardian and student signatures, affirming their understanding of the terms and conditions.

Uploaded by

Edwin Antonio
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/ 2

OFFICE OF STUDENTS AFFAIRS

PARENTAL GUARDIAN PERMIT FORM


FOR OFF-CAMPUS ACTIVITIES
To be accomplished in duplicate. One copy to be retained by the parent/guardian; the other copy for Wesleyan
University Philippines.

Name of Student ID Number

Name of Activity

Place of Activity

Departure Date Departure Time

Arrival Date Arrival Time

College/Department/Office/Unit

Faculty/Staff In-Charge Immediate Supervisor


(Signature over printed name) (Signature over printed name)
Contact Number: Contact Number:

PERMISSION
1. Together with my son/daughter, I know that the University and its offers, faculty, and staff are
expected to exercise the legal diligence required for the safety and well-being of my child for the
duration and the place, date, and time of the activity as stated.
2. The legal diligence would include oral and written instruction, whether given before or during the
activity, that if followed, would ensure the safety of my son/daughter.
3. If my son/daughter disregards or fails to follow this instruction or should act on his/her own, I,
together with my son/daughter, shall have no claims against the University, its officers, faculty/staff-
in-charge should any damage be caused, or liability be incurred to property or person.
4. (For academic-related activity) We understand and affirm that this activity is not
compulsory/mandatory. We understand that the other requirements of comparable academic weight
may be imposed on my son/daughter in lieu of this activity.
5. Please allow my son/daughter to get off at ____________________ which is near our place of
residence, after the activity. My son/daughter shall take full responsibility for him/her upon
disembarking your designated transportation.

___________________________ _________________________
Parent/Guardian Student
(Signature over printed name) (Signature over printed name)

ACAD-SPS-OSA-FM-020 Rev 0 Effective 15 Nov 2021


Contact Number: Contact Number:

ACAD-SPS-OSA-FM-020 Rev 0 Effective 15 Nov 2021

You might also like