The document is a consent form for a Leadership Training Seminar at Cor Jesu College scheduled for August 23, 2024. It outlines the seminar's objectives, the need for parental consent, and includes a health declaration section for students. Parents must confirm their permission for their child to attend, acknowledging the school's commitment to safety while also recognizing that the school is not liable for all risks.
The document is a consent form for a Leadership Training Seminar at Cor Jesu College scheduled for August 23, 2024. It outlines the seminar's objectives, the need for parental consent, and includes a health declaration section for students. Parents must confirm their permission for their child to attend, acknowledging the school's commitment to safety while also recognizing that the school is not liable for all risks.
The document is a consent form for a Leadership Training Seminar at Cor Jesu College scheduled for August 23, 2024. It outlines the seminar's objectives, the need for parental consent, and includes a health declaration section for students. Parents must confirm their permission for their child to attend, acknowledging the school's commitment to safety while also recognizing that the school is not liable for all risks.
The document is a consent form for a Leadership Training Seminar at Cor Jesu College scheduled for August 23, 2024. It outlines the seminar's objectives, the need for parental consent, and includes a health declaration section for students. Parents must confirm their permission for their child to attend, acknowledging the school's commitment to safety while also recognizing that the school is not liable for all risks.
CITY OF DIGOS TITLE OF THE ACTIVITY: ORGANIZATION/CLASS /COLLEGE /OFFICE Leadership Training Seminar CSG DATE: August 23, 2024 VENUE / ADDRESS: STARTING TIME FINISHING TIME CJC Gymnasium 8: 00 am 5:00 pm OBJECTIVES: 1. To convene the student leaders of Cor Jesu College - College Department for the school year 2024 - 2025. 2. To provide an opportunity for the student leaders to participate in the rapport-building activity. 3. To reconnect the resolute student leaders towards Cor Jesian embodiment of service and leadership.
TYPE OF ACTIVITY (Please check the category that applies to the activity)
Seminar / Training / Conference / Meeting Retreat / Recollections
Community Engagement / Immersion/ Exposure Spirituality and Religious Formation ✔ Capacity and Teambuilding Competitions (Spe cify) ______________________________ Practices/ Rehearsals __________________________ Others (Specify) _______________________ ____________ MODERATOR / FACULTY / STAFF ATTENDING THE ACTIVITY : ENDORSED BY: I hereby confirm and commit to attend the aforementioned activity and exercise due diligence in looking after the safety and well-being LOUELLA MAY V. PLAZA of the participants, especially the students. Student Activity Coordinator Signature Over Printed Name _____________________________ ATTENDING MODERATOR/FACULTY/STAFF APPROVED BY: Signature Over Printed Name College/Office : Contact No.: _________________________________________ Date Signed: MIGUELITO R. ESPINOSA Director, Student Services
TO THE PARENT/GUARDIAN: Please check one of the options below to confirm your permission or non -permission of your son’s / daughter’s attendance to the activity.
[ ] I am permitting my son/daughter to join the above activity. I recognize that the School is committed to exercise due diligenc e to ensure my son’s / daughter’s safety and well-being. However, I understand that the School is not an insurer of all risks and eventualities. Hence, I hereby confirm that I have reminded my son/daughter to follow all the rules and regulations of the sc hool and activity.
[ ] I am not permitting my son/daughter to join the above activity.
Permitted: I attest to the fact that I secured the permission of my parent/guardian
as evidenced by his/her signature.
_____________________________ ___________________________ PARENT/GUARDIAN STUDENT Signature Over Printed Name Signature Over Printed Name Relationship: [ ] Mother [ ] Father [ ] Others: Pls. Specify: Student I.D. No.: Address: Course & Year: Contact No: Date Signed Date Signed:
HEALTH DECLARATION: This health declaration will help the organizers understand the health condition of the attending student so as to provide timely support and to make necessary arrangements in the event of an emergency. Please provide accurate data.
1. Have you ever suffered from any allergies? Yes ___ No ___If yes, provide details ________________________________
2. Are you on regular medication? Yes ___ No ___If yes, provide details _________________________________
3. Are you on special diet? Yes ___ No ___If yes, provide details _________________________________ Remarks: If you have an allergy, medical treatment or health issues, the organizers require that you seek your doctor’s advice before joining this event and submit documentary proofs (e.g. Doctor’s certification or medical allergy card)
AUTHORIZATION AND WAIVER:
I confirm that all the information herein are correct and accurate to the best of my knowledge and I authorize the organizer to use with discretion the information contained herein as the organizer deem necessary in view of my participation to this activity. I hereby attach my signature below to vouch for the veracity of the above statements.
Student’s Full Name: (Family name, First name, middle Initial) Signature: Date signed:
Note: Organizers should facilitate the collection and checking of the parents’ consent before the activity. Copies should be kept at hand for easy access of information with regard to medical or health concern of the participants.
