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No.

:
Parental Consent Form

Name of Student Organization: Bulacan State University Debate Society

Name of Activity: BSUDS KAPIHAN: Debate Seminar (1st installment)

Office/ College/ other Agency who initiated the Activity: Bulacan State University Debate Society

Nature of Activity: Co-Curricular Extra-Curricular

Venue: Bulacan State University – Main Campus (COED Conference Hall)

Inclusive Dates: October 21, 2023

I allow my son/daughter to attend the activity.


I trust that the organizers of this activity will take due diligence to ensure the safety of my
son/daughter as a participant.

I do not allow my son/daughter to attend the activity.

Name of Student: ____________________________________________________________

Name of Parent/Guardian: _____________________________________________________

Phone/Cell phone number: ____________________________________________________

Address: ___________________________________________________________________

Specimen Signatures: ___________ ___________ ___________

Note:
● Attach a copy of the Parent’s/Guardian’s identification card with signature.
BulSU-OP-OSO-02F5 Page 1 of 1 Revision: 2

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