SAWO Form 06

Republic of the Philippines

Student Affairs and Welfare Office

Mindanao University of Science and Technology

(Formerly Mindanao Polytechnic State College)

Lapasan, Cagayan de Oro City

Tel. Nos.: (088) 856-1738/856-1739; Tel. Fax: (088) 856-4696

PARENT/GUARDIAN CONSENT REQUEST FORM

_____________________
Date

College of
Department of

____________________
____________________

TO WHOM IT MAY CONCERN:

This is to certify that I allowed my son / daughter / ward to join the Educational Tour/ SeminarWorkshop/Conference/Convention.
Name of son / daughter
Name of Activity
Date of Activity
Place(s) to Visit

Thank you very much!

Yours truly,
______________________________
Name of Student
(Signature-Over-Printed Name)

APPROVED:
__________________________
Name of Parent/ Guardian
(Signature-Over-Printed Name)

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STUDENT WAIVER
I,___________________________________
(name)
presently
enrolled
in
___________________
______________ (course/ year & section) present myself to join the _________________________as part of our
school / student activity and do hereby pledge that:
1.

I will obey and abide the rules and regulations promulgated, enforced by the officials of the University
for the protection and safety of all;

2.

That I hereby waived and renounce my rights to all damages, hospitalization, and the like and I will not
hold the employees or staff of MUST responsible for any misfortune, injury, or accident be slight or
serious, that may happen in connection with the activities or requirements. The cause of which will be
attributable to my acts of my disobedience, negligence, and the offense of my heading to advice, warning,
precaution, and safety rules that were read to me by my adviser before the start of the activity.

That the content of this waiver was read and explained to me before I affix my name and signature this ______
day of ______________freely and voluntarily.
Thank you very much!

Yours truly,
______________________________
Name of Student
(Signature-Over-Printed Name)
Copies for Distribution:
1.
College file
2.
Student Affairs and Welfare Office (SAWO)

3.

Student file

APPROVED:
__________________________
Name of Parent/ Guardian
(Signature-Over-Printed Name)