Republic of the Philippines

EULOGIO “AMANG” RODRIGUEZ

INSTITUTE OF SCIENCE AND TECHNOLOGY
Nagtahan, Sampaloc, Manila

INSTITUTE STUDENT GOVERNMENT

LETTER OF CONSENT

I, _______________________ ________________________________, Parent/Guardian of

_____________________________________________________, hereby acknowledge that I
have given him/her my consent and permission to participate at the ALUMNI AND
STUDENT NIGHT 2024 event that will be held on January 26, 2024, at 6:00 p.m. to 12:00
p.m. at the EULOGIO “AMANG RODRIGUEZ INSTITUTE SCIENCE AND
TECHNOLOGY located at Nagtahan Sampaloc, Manila. I understand that the school and
organizers will do their best to ensure the safety of the participants, and I will not hold them
liable or responsible for the possible occurrence of any unforeseen circumstances.

________________________________
Parent/Guardian Signature under Printed Name

CONFIDENTIALITY AGREEMENT

The organizers ensure that any information and documents transmitted is intended only and
solely prior for the use of the recipient and may not be reproduced or disseminated without the
owner’s written consent. Both parties understand and agree that all information released is
under the protection of Republic Act No. 10173, also known as the Data Privacy Act of 2012
that aims to protect personal data information and communications systems both in the
government and the private sector. Any illegal use of the documents and information is
prohibited and anyone shall be held responsible.

I have read and understand the written statement above and will adhere to the
confidentiality agreement.

Signed by:

____________________
PARENT/GUARDIAN