OFFICE OF THE STUDENT INTERNSHIP PROGRAM

PARENT’S CONSENT

This is to certify that I allow my son/daughter _________________ to undergo Practicum (Skills

Development) for 240 hours this Second Semester of SY 2020-2021.

I understand that the school and its personnel are not held liable/responsible for any accident that
may occur as a result of any deliberate disregard on the student’s part to follow and observe norms of safety
during the activity.

In witness hereof we have hereunto affixed our signature in this affidavit this
_____________________day of ____________________________

______________________ _____________________________
Parent/Guardian Printed Name ‘and Signature Student Printed Name and Signature

Noted:

EGIE-DAYAN D. ALCANTARA
CAA OJT/OIP Coordinator