CONSENT REQUEST FORM

TO WHOM IT MAY CONCERN:

This is to certify that I allowed my son/daughter/ward to join the highlight activity of the COC
Collide 2023: Student Fair 2023.

Student name
Name of activity Collidescope: Acquaintance and Awards
Date and time March 2, 2023, 1:00 pm to 6:00 pm
Venue The Event Center, Level 3
SM City Urdaneta Central

Thank you very much!

Yours truly, DARYL Approved: NORMAN

DARYL JAMES O NATIVIDAD NORMAN P. NATIVIDAD

Name of student Name of parent/guardian
(Signature over printed name) (Signature over printed name)

I, DARYL JAMES O NATIVIDAD(student name), presently enrolled in Bachelor of Science in

Information Technology, IT-E (block), present myself to join the Collidescope: Acquaintance
and Awards as part of our school/student activity and do hereby pledge:

1. That I will obey and abide by the rules and regulations promulgated, enforced by the
officials of the University for the protection and safety of all.

2. That I hereby waived and renounce my rights to all damages, hospitalization, and the
like and I will not hold the employees or staff of MUST responsible for any misfortune,
injury, or accident be slight or serious, that may happen in connection with the activities
or requirements. The cause of which will be attributable to my acts of my disobedience,
negligence, and the offense of my heading to advice, warning, precaution, and safety
rules that were read to me by my adviser before the start of the activity.

That the content of this waiver was read and explained to me before I affix my name and
signature this day of , 2023 freely and voluntarily.

Yours truly, DARYL Approved: NORMAN

DARYL JAMES O. NATIVIDAD NORMAN P. NATIVIDAD

Name of student Name of parent/guardian
(Signature over printed name) (Signature over printed name)