Ref. No.

SPS SA-SPC 0036

Status: Rev. 02
Date Issued: July 2010

STATEMENT OF PARENTAL CONSENT/WAIVER

College: COLLEGE OF CRIMINAL JUSTICE EDUATION___
APRIL 10, 2017 ____
Dear Parents/Guardian: Date

Your son/daughter has expressed his/her intention of joining the Pre - Internship Training Program
Sponsored by the College of Criminal Justice Education , to be held on May 22 27, 2017,
7:30am 5:00pm. at SJIT, Covered Court, Annex Campus, T.Calo St., Butuan City.

Should you allow your son/daughter to join the aforementioned activity, kindly fill out the Reply Slip below
and return the same to Dr. Marjune I. Millones of the College of Criminal Justice Education on or
(ORGANIZER) (CLASS/ORGANIZATION/COLLEGE)
before April 29, 2017 .
(DEADLINE FOR SUBMISSION OF PARENTAL CONSENT)

Rest assured that their Faculty/Adviser will accompany them during the activity. Should there be a need
for you to communicate with your son/daughter, kindly call 09178060849/09998853340 .
(CONTACT # OF DEAN/ADVISER)
Sincerely yours,
DR. MARJUNE I. MILLONES ______
SIGNATURE OVER PRINTED NAME OF THE FACULTY

Endorsed:

DR. MARJUNE I. MILLONES_____

SIGNATURE OVER PRINTED NAME OF THE DEAN

====================================================================================
REPLY SLIP
Please be informed that the undersigned poses no objection to the participation of my son/daughter
___________________________________________ of________________________________________
(NAME OF SON/DAUGHTER) (NAME OF ADVISER/FACULTY)
In the _____________________________________________________________________________
(TITLE OF THE ACTIVITY OR EVENT)
sponsored by the ___________________________________________________________________
(NAME OF SPONSORING CLASS/ORGANIZATION)
To be held on ______________________________________ at ____________________________________
(DATE & TIME OF ACTIVITY) (LOCATION: COMPLETE ADDRESS OF VENUE)
Together with my son/daughter, I know that the school and its faculty are expected to exercise the legal
diligence required for the safety and well-being of my son/daughter for the duration of the activity as stated.
This legal diligence would include oral or written instructions, whether given before or during the activity,
that if followed, would ensure the safety of my son/daughter.
I hereby give consent for him/her to take part in the said event.
If my son/daughter disregards or fails to follow those instructions or should act on his/her own, I,
together with my son/daughter, shall have no claims against the School, its officers, faculty and staff in charge
should any damage be caused or liability be incurred to property or person.
_____________________________________________ ____________________
SIGNATURE OVER PRINTED NAME OF PARENT/GUARDIAN DATE
Address: _______________________________________ Contact No. ____________________

NOTE: Filled out Parental Consent should be checked by the Dean. Students who did not submit their filled out waivers shall not be allowed to join the off
campus activity