Republic of the Philippines

UNIVERSITY OF RIZAL SYSTEM

Province of Rizal
Office of Student Development Services
Student Organization Unit
OSDS Bldg., URS Morong Campus, Telephone: 584-5283, E-mail: ursmorongstudorg@urs.edu.ph

PARENTAL CONSENT FOR STUDENT ACTIVITIES

I hereby willingly and voluntarily give consent to _____________________________, to

(NAME OF STUDENT)

participate in the _________________________________________________to be held at

(STUDENT ACTIVITY)
_____________________________________ on ___________________________.
(VENUE) (DATE)

I have considered the benefits that my child will derive from participating in this activity,
with the understanding that due care and precaution will be observed to ensure the
comfort and safety of the delegates/participants to this activity and that I shall not hold
the parties responsible for any untoward incident that may happen beyond their control.

Conforme:

_______________________________ ______________________________
(Signature over Printed Name) (Signature over Printed Name)
Parent/Guardian Student

Recommending Approval:

_______________________________ ______________________________
Dean, College of _______________ Campus OSDS Coordinator

Approved:

__________________________________
Director, __________________ Campus

URS-AA-SS-STO-F-2017-04 Rev. 01 Effectivity Date: October 21, 2020