La Salle University

Ozamiz City

PARENTAL/ GUARDIAN CONSENT FORM

Student’s Name: Grade/ Section: GRADE 12-STEM 1

Name of Activity: RESEARCH PROPOSAL DEFENSE Venue: BVM AVR, LSU-IS
Date of Activity: December 9, 2023 Time Start:8:00AM
Time Finish: 12:00 NN

Faculty Moderator In Charge Approved:

MR. JOHN MICHAEL B. ACUNO, LPT, MAEn DR. GLENNA C. TAC-AN

Research Adviser Principal

PARENTAL CONSENT

I hereby willingly voluntarily consent to the participation of my child in the aforementioned activity. I have
considered the benefits that he/she will derive by participating in this undertaking. I understand that I will not
hold La Salle University Integrated School and/or any party responsible for any untoward incident which may
happen in the course or duration of the activity as long as proper care and due diligence are observed to ensure the
safety of the students. I also understand that the activity is sanctioned as an extension of a school undertaking and
therefore all rules and policies pertinent to such are applicable and in force.

__________________________________ ____________________
Signature Over Printed Name of Parent/ Guardian Date Upon Signing

__________________________________________________________________________________________
La Salle University
Ozamiz City

PARENTAL/ GUARDIAN CONSENT FORM

Student’s Name: Grade/ Section: GRADE 12-STEM 1

Name of Activity: RESEARCH PROPOSAL DEFENSE Venue: BVM AVR, LSU-IS
Date of Activity: December 9, 2023 Time Start:8:00AM
Time Finish: 12:00 NN

Faculty Moderator In Charge Approved:

MR. JOHN MICHAEL B. ACUNO, LPT, MAEn GLENNA C. TAC-AN, PhD

Research Adviser Principal

PARENTAL CONSENT

I hereby willingly voluntarily consent to the participation of my child in the aforementioned activity. I have
considered the benefits that he/she will derive by participating in this undertaking. I understand that I will not
hold La Salle University Integrated School and/or any party responsible for any untoward incident which may
happen in the course or duration of the activity as long as proper care and due diligence are observed to ensure the
safety of the students. I also understand that the activity is sanctioned as an extension of a school undertaking and
therefore all rules and policies pertinent to such are applicable and in force.

__________________________________ ____________________
Signature Over Printed Name of Parent/ Guardian Date Upon Signing