JESUS THE CENTER FELLOWSHIP OF THE PHILIPPINE ISLAND

Palnab del Sur Virac, Catanduanes

Email Address: jcfpiphilippines@yahoo.com

PARENTAL CONSENT
This is to certify that I have given full consent and permission for my son/daughter
_________________________________ to participate in the AFFINITY GROUPS CAMP 2023 to be held at
Calatagan High School, Virac, Catanduanes on July 27-29, 2023.

I have considered the benefits that my son/daughter will derive from his/her participation in the
aforementioned activity with the understanding that every precaution is to be taken to ensure his/her safety in
the Camp. I shall not hold the Camp Staff and the JCFPI Church responsible for any untoward accident that
may happen beyond their control.

______________________________________
Signature over Printed Name of Parent/ Guardian
______________________________________
CP# of Parent/ Guardian
_________________________________________________
Present Address
__________________________
Date

AGC 2023 PRE-REGISTRATION

Name: __________________________________________ Nickname: __________________

Age: __________________________________ Sex: _________ Civil Status: _______________
Home Address: _______________________________________________________________
Contact Number: __________________________________
Name of Affinity Group Leader (leave it blank if NOT member of AG) _____________________
CP# of parent or guardian: ____________________________________________
Religion: _________________________________________
Food Allergy: ______________________________________
If under medical treatment, please specify medical condition and drug intake) _____________

Expectations:
_____________________________________________________________________________
_____________________________________________________________________________
__________________________________________________________________

___________________________ _____________________
Signature Over Printed Name Date Signed

SEE YOU AND GOD BLESS!