Parent Consent Form for Arnis Training

Name of Child ………………………………… Date of Birth ………………………...……………….……

Parent/ Guardian ………………………………………………………………………………………......

Address: ……………………………………………………………………………………...…………………….
Mobile: …………………………………………………….. e-mail: ……………………………........................

Does your child suffer from any medical conditions/allergies that the program should be aware of
(including any current medication) .........................................................................................................
………...…………………….
Please provide details of medication that must be administered: ………………………………………….
……………………………………………………………………………………………………………………..
Emergency contact details: (If different from above)
Name: ……………………………………………………………… Telephone no: ……………..…………
Relationship to child: ……………………………………………………………………………….................

CONSENT (please read carefully)

i. I agree to my son/ daughter taking part in the activities of the

Arnis/program.
ii. I confirm to the best of my knowledge that my son/ daughter does
not suffer from any medical condition other than those listed
above.
iii. I consent to my son/ daughter travelling by any form of public
transport, minibus or motor vehicle organised by the Living
Together/Vivre ensemble Team to any event in which the program
is participating.
iv. I agree to abide by the COVID -19 rules and guidance for the Arnis training
v. I hereby authorize and give permission for coaches and administrator to ask general questions
related to COVID-19 symptoms and take appropriate actions in reporting any concerns if
necessary, prior to training. That emergency medical treatment to be rendered for any injury
received while participating in any supervised trainings. This authorization includes, but is not
limited to, any treatment deemed necessary by certified personnel, physicians, hospital
emergency room physicians and hospitals.
vi. I hereby release the Tacurong Pilot Elementary School and all school personnel for any and all
liability associated with such necessary treatment related to physical injury and/or illnesses
during the training.
vii. In addition. I accept full responsibility for medical and hospital expenses and any other related
expenses and do hereby hold harmless the Hinds County School District and the Board of
Trustees, their agents or assignees, of responsibility for any such injury or illness and waive
any and all claims which may-arise against them. My signature below indicates that I have been
given a copy of the HCSD Summer Workout A

Signed ………………………………….....................… (Parent/ Guardian) Date: ……………………………