Form D – Parent’s Permit (Note-to-be submitted to the DSA Office two days before the actual date of the

off-campus activity)

PARENT’S PERMIT

I, ________________________________, parent/guardian of ___________________________________

(Name of parent) (Name of student)
hereby permits my son/daughter to join the ________________________________________________
(Nature of off-campus activity)
on _________________________ at _______________________________________________________
(Date) (Place)
Aware of all the possible risks, I hereby discharge the organizing group and the University of Nueva
Caceres from any liability from any incident caused in violation of the guidelines/house rules set by the
organizing group.

____________________________
Printed name of parents/guardian

___________________________
Signature

PARENT’S PERMIT

I, ________________________________, parent/guardian of ___________________________________

(Name of parent) (Name of student)
hereby permits my son/daughter to join the ________________________________________________
(Nature of off-campus activity)
on _________________________ at _______________________________________________________
(Date) (Place)
Aware of all the possible risks, I hereby discharge the organizing group and the University of Nueva
Caceres from any liability from any incident caused in violation of the guidelines/house rules set by the
organizing group.

____________________________
Printed name of parents/guardian

___________________________
Signature