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APPLICATION TO AmND DAY CAMP

PARENT/ GUARDIAN Nome:_-;;::==::- ---;::::--:- -----------

(Sumame), (Given) (Mlddle Name)
5<oUtS Name:.__(_SU_m ...,, ----G-- Nick Name:
_
-·-1 · 1 1Middle Name)
School:------::-:-=:-::-----------Dlslrlct:
• : Dote of Birth: Pl- of Birth:
HomeAddms:
Contact N ------:--- - E·mlll Addreu:
Rellaton:
•·'- --- Oaupatlon: - Posltlon/ lltlt:
H_, Sldlls/ TaltnU:
Mtdlcal Requirementsol SCOUTS (II any):

(Slgrmure owr Prin ted Name)

ed by:

PARENTS PERMIT
. p.1rent./auardlan
ol allow him/her to attend the DAY CAMP on
November 19,2022, at Sllanganan Elementary School,Phase3, Bagong Silana Caloocan City.

W A I'\f R R
I am eware ol the risks connected withttendlng thisevent on lhlsdate. Iagree to not hold accountable
or bring legal action against th• council,their activity officers, unit leaders,or council staff.This
waive< releases the council from all liabffity relating to ln)urles that moy occur on location
before,during, or
after activity.

Sy signing this agreement, I agree to hold the council entirely lree from any liability,Including
financial responsiblllty for in)uries Incurred, regardless of the reason• or circumstances.

Iacknowledge the risk Involved with this actMty Including. but not limited to,muscle tears,sptains,
and other physica l Injuries.I certify that mychild's participation Isvoluntary, and I haw been
madeaware of the risks. Additionally, I guarantee that my child does not have any conditions that
may Increase any
likelihood of injury.

My child wlll make every effon mobey the activity officers and all his unit leaden, all safety rules, and
willask tor clarification if needed.

Parent/
Guardian
Parent's/Guardian's Signature PTlnted Name Cellphone
Number:--
------ Date