STATEMENT OF PARENTAL
CONSENT
Dear Parents / Guardians:
Your son / daughter / ward has expressed his / her intentions in joining the FEU Diliman Musiklab Senior High
School Club, of which your child is part, to participate in the upcoming Buwan ng Wika/UN Celebration. In
preparation for the said event, the FEU Diliman Musiklab will have rehearsals to be held at FEU Diliman Main
Building M305 & M307 from September 13, 2023, to October 18, 2023, every Tuesday, Wednesday, and Friday
by necessity. We are asking you to allow your child to stay at least until 6:00 PM after class hours to participate
in this activity.
Should you allow your son / daughter / ward to join the aforementioned activity, kindly accomplish the attached
Parent’s / Guardian Consent Form and return the same to the FEU Diliman Musiklab Officers on or at least a day
before the activity.
Rest assured that the Moderators will be available during the activity.
Sincerely yours,
Mr. Nickole V. Mompil
Faculty/ Club Moderator
Senior High School
Department
Approved by:
Senior High School Coordinator
Mr. Ralph F. Lipalam
Senior High School Director
Mr. Diomedes C. Capacio Jr.
✄
REPLY SLIP
I permit my son/daughter/ward , to attend
FULL NAME YEAR & DEGREE PROGRAM
Club Rehearsals organized by the FEU Diliman Musiklab to be held at
FEU Main Building 305&306 from September 13 to October 18 4:30-6:00
I trust and recognize the utmost diligence observed by the organizers or authorized representatives in supervising the above -
mentioned activity to prevent any untoward incident that may happen. I hereby waive any claim against the school authorities or
its representatives for any injury that may happen to my child while he/she takes part in any of these activities after the school
representatives have exhausted all the necessary precautions. I am aware that in the event of any injury that happens to my child
while he/she takes part in any of these activities, medical and related expenses that may be incurred in the treatment of my child,
over and above those covered by the applicable school accident insurance, will be borne by me.
Signature over printed name Signature over printed name
Parent / Guardian Student
Contact Number Contact Number
NOTE: A copy of an accomplished Reply Slip must be forwarded to the Student Activities and Development Unit (SADU), Admin
Building. Original copy must be kept by the Faculty / Associate In-charge. Students who did not submit their accomplished Reply
Slip shall not be allowed to join the off-campus activity.
FO-ACSERV-SADU-016-DIL/18OCT2021/REV.0