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ACTIVITY CONSENT FORM

Details of Activity:

What:

When:

Where:

I/We, , the parents/guardian of ,a

(Name of Parent/Guardian) (Name of Student) (Grade/YearLevel)

student of Universidad de Zamboanga.

After due consideration, I/we: (Please choose one)

Give my/our consent and permission for my/our child to participate in the school activity Do

not give my/our consent and permission for my/our child to participate in the school activity By

giving my/our consent and signing this form, I acknowledge and understand that:

1. There may be inherent risks associated with the aforementioned activity. I am/We are
aware that the school takes measures to ensure the safety and well-being of the students
during the activity. However, I/we acknowledge that the school is not an insurer against all
kinds of risks and it is impossible to eliminate all risks. As such, I/we voluntarily assume and
accept full responsibility for any injury, loss, or damage that may occur.

2. School rules and regulations will be in effect during the activity, and I/we bind
myself/ourselves to make sure that my/our child understands that it is important for his/her
safety, and for the safety of the group, that all rules and regulations given by the teacher-in-
charge or officer-in-charge are obeyed.

3. My/Our child’s participation in the activity is entirely voluntary. In consideration of

my/our child being allowed to participate, with full knowledge of the risks involved, and after
having been provided an opportunity to ask questions, I/we hereby waive any and all claims,
demands, actions, or causes of action against the school, its employees, agents, volunteers,
and representatives, arising from any injury, loss, or damage that may occur as a result of
my/our child's participation in the activity.
 By signing below, I acknowledge that I carefully read and fully understand the terms of this
consent and waiver form, and I agree to its contents. I make this solemn declaration knowing that it
has the same legal force and effect as if made under oath.
Parents / Guardian: Student:

Signature over Printed Name / Date Signature over Printed Name / Date

Emergency Contact Details:

Contact
Person:
Relationship
with Student: Phone/Mobile Number:

FO-DSAS-096; Revision 0; June 10, 2023