UNIVERSITY OF THE EAST Manila Caloocan PARENT / GUARDIAN CONSENT FORM

FORM C

I hereby give my permission to ______________________________________________ to attend the Off-Campus activity detailed below: Name of Off-Campus Activity: 1st A-BEST National Congress Purposes: 1. To supplement business education for students through various business and education related topics/sessions; 2. To enable students participate to a National Conference; 3. To enhance students interpersonal skills by enabling them to deal and interact with students from other schools. Destinations: Teachers Camp, Baguio City Full Amount: 3,400 (Live-in Package), 2,700 (Live-out Package) Dates: Jan. 24-26, 2014 Duration: 3 days Departure Time: (Depends on Trip Ticket) Arrival Time: (Depends on Trip Ticket) Boarding and Drop-off Area: (Depends on the chosen Bus Terminal) Mode of Transportation: (Public Utility Bus) Proponents In-Charge: Profs. Jayme C. Ignacio & Marissa Lanuza
Please check:

Cellphone No: 09052272053 / 09175466752

I received a detailed itinerary of the off-campus activity [ ] YES [ ] NO I received a list of things that student should/should not bring [ ] YES [ ] NO =========================================================================================== As parent/ guardian of the above named student, I have fully read the off-campus activity itinerary and I understand that there are risks and hazards associated with participation in these activities. I hereby authorize qualified emergency medical professionals to examine and in the event of serious injury or illness, administer emergency care to the above named student. I understand every effort will be made to contact me to explain the nature of the problem prior to any involved treatment. In the event it becomes necessary for the proponent in-charge to obtain emergency care for above named student, neither he/she nor the University assumes financial liability for the expenses incurred because of the accident, injury, illness, and/or unforeseen circumstances. The above stated Off-Campus activity is an extension of the Universitys educational program and requires that students manner and conduct be in accordance with the University rules and regulations. ______________________________________________ PARENT/GUARDIAN (Signature over printed name) ______________________ CELLPHONE NO. _______________________ HOME PHONE NO. _________________________ DATE SIGNED ________________________ WORK PHONE NO.

=========================================================================================== I hereby declare that I am physically fit and voluntarily joining the above stated Off- Campus activity. I release the University of the East from any liability arising from or may be attributed to my participation in this event. I pledge that my manners and conduct will, at all times, reflect credit upon my University, my parents, and myself. I understand that the University rules and regulations apply for the entire duration of our Off-Campus activity.

___________________________________________________ PARTICIPATING STUDENT (Signature over printed name)

________________________ DATE SIGNED

Noted by: ____________________________________________ PARENT/GUARDIAN (Signature over printed name)

________________________ DATE SIGNED