Bicol University

Legazpi City

PARENT’S/GUARDIAN’S PERMIT AND WAIVER FOR IN-PERSON CLASSES

(Undergraduate Students)

I/we, parent (s)/guardian(s) of ________________________________, ______

Surname, Given Name MI Age

years old, a _______ student of ______________________________, of the

Year level Course
______________________________________________ has my/our permission to
College/Campus
participate in the in-person classes for blended learning of Bicol University, starting this

SY 2022-2023.

This certifies further that I/we is/are aware of the risks involved in the conduct of
the in-person face-to-face classes and the health and safety protocols instituted by the
college to minimize the risks of COVID-19.

Signature
Name
Relationship:
Contact No/s:
Address
BU-F-VPAA-25-A Revision No. 0
Effective Date: 22 July 2022