PARENTS’ CONSENT AND WAIVER* Student Trip/Travel and/or Participation ‘The undersigned parentfslquardian whose printed namels and signaturals appear below 2. Atbona-fde MSU student athe oolege/schoal of NAME OF COLLEGE: 3. Are aware that said student will be 2 part of a school/courseiciass retated travetirip as follows: Destination: ve Purpose ¢. Inclusive dates 4. Means of transportation. © Lachingftoardaseanmoceton: 1, Monetary ContributioniExy 4 ve understand tha fe on & pat ol the student's academic progranvccurse and as such live hereby give our permission and consent for said student to travel as abowe described and sj 5. By vitue of this document, Wwe unconditionally waive any and al claims or causes of actions agen the Mariano Marcos State University (MSU), or ay of its faculty, personnel or ofciets that may arise 3s a result of said tinfravelpartciation, such as accident, andior similar unforeseen events and acts of God, in whatever nature of form. This waiver does nol however over intentional acts; oss, damage or injury that resuts thereltom shall be the Habilty of the ‘person who intentionally caused the damage, loss or injury 6. IMPORTANT. 2) this document is signed by only one parent, please slale belaw the reason why the other parent’ signalure was nol cblained. By affiang hisiner signature the signing parent heredy takes full responsibility for this consanUwaiver. ifthis document is signed by a guardian, please state below the nature of the guardianship ‘elation and the legal basis thereof. The guardian or anyone who claims fo act as such takes full responsiblity fr this consentwaiver. b) PARENT/GUARDIAN ARENT/GUARDIAN [SIGNATURE OVER PRINTED NAME) (SIGHATURE OVER PRINTED NAME} PERMANENT ADDRESS: CONTACT NUMBER We verified all the information/data herein provided and they are true and correct to our awn personal information and belief. Dean Depariment Chair FacultyiCoordinator “Presse do nats or oily tis document. Al informattonitale required musi be provided corey and accurately. This ‘cum must accompany hs eter request atime tha requests stmiied