Parent Consent Form Investiture

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Southern Luzon Region

Quezon Girl Scout Council


Tiaong District I
ANASTACIA ELEMENTARY SCHOOL

PARENT/GUARDIAN CONSENT FORM

Name of Learner: _____________________________________________________Grade & Section: ______________


Parent’s/Guardian’s Name: _________________________________ Relationship to the Learner:__________________
Home Address: _____________________________________________________
Contact Numbers: ____________________________________________________
Title of the Activity: 2023 INVESTITURE CEREMONY
Venue: _________ ELEMENTARY SCHOOL, ___________________
Date of Activity: MARCH 18, 2023 (SATURDAY), 9:00 AM

As the parent/guardian of the above mentioned learner, I hereby acknowledge that I have been informed of the
details of the activity. Furthermore, I understand the risk associated with activity and agree that the rules and regulations
established for the activity are for the safety and security of the participants, and thus agree to instruct my child or
children to obey them.
Having understood all the aforementioned, I hereby consent to allow my child/children to participate,
acknowledging all the foregoing, I am also solely responsible for providing travel insurance and any expenses for my
child/children participation in the activity.

_______________________________ _________________
Parent/Guardian Name and Signature Date

Notes: (Other information you may wish to inform the teacher, such as child’s medical condition, etc)

Southern Luzon Region


Quezon Girl Scout Council
Tiaong District I
ANASTACIA ELEMENTARY SCHOOL

PARENT/GUARDIAN CONSENT FORM

Name of Learner: _____________________________________________________Grade & Section: ______________


Parent’s/Guardian’s Name: _________________________________ Relationship to the Learner:__________________
Home Address: _____________________________________________________
Contact Numbers: ____________________________________________________
Title of the Activity: 2023 INVESTITURE CEREMONY
Venue: ____________ ELEMENTARY SCHOOL, __________________________
Date of Activity: MARCH 18, 2023 (SATURDAY), 9:00 AM

As the parent/guardian of the above mentioned learner, I hereby acknowledge that I have been informed of the
details of the activity. Furthermore, I understand the risk associated with activity and agree that the rules and regulations
established for the activity are for the safety and security of the participants, and thus agree to instruct my child or
children to obey them.
Having understood all the aforementioned, I hereby consent to allow my child/children to participate,
acknowledging all the foregoing, I am also solely responsible for providing travel insurance and any expenses for my
child/children participation in the activity.

_______________________________ _________________
Parent/Guardian Name and Signature Date

Notes: (Other information you may wish to inform the teacher, such as child’s medical condition, etc)

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