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    Parent Consent 2023

    Uploaded by

    Reximie D. Dollete Jr.
    This document contains a parent consent form and medical certificate for a student athlete to participate in sports competitions organized by RIPRISA (Rizal Private Schools Association). The parent consent form allows the student to participate and agrees not to hold the school responsible for any incidents. The medical certificate is signed by a physician certifying that the student is physically fit to compete based on a medical examination. It includes personal information about the student athlete.

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    © All Rights Reserved
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    Parent Consent 2023

    Uploaded by

    Reximie D. Dollete Jr.
    91 views2 pages
    This document contains a parent consent form and medical certificate for a student athlete to participate in sports competitions organized by RIPRISA (Rizal Private Schools Association). The parent consent form allows the student to participate and agrees not to hold the school responsible for any incidents. The medical certificate is signed by a physician certifying that the student is physically fit to compete based on a medical examination. It includes personal information about the student athlete.

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    Original Title

    PARENT CONSENT 2023

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    This document contains a parent consent form and medical certificate for a student athlete to participate in sports competitions organized by RIPRISA (Rizal Private Schools Association). The parent consent form allows the student to participate and agrees not to hold the school responsible for any incidents. The medical certificate is signed by a physician certifying that the student is physically fit to compete based on a medical examination. It includes personal information about the student athlete.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    91 views2 pages

    Parent Consent 2023

    Uploaded by

    Reximie D. Dollete Jr.
    This document contains a parent consent form and medical certificate for a student athlete to participate in sports competitions organized by RIPRISA (Rizal Private Schools Association). The parent consent form allows the student to participate and agrees not to hold the school responsible for any incidents. The medical certificate is signed by a physician certifying that the student is physically fit to compete based on a medical examination. It includes personal information about the student athlete.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    RIPRISA (Rizal Private Schools Association)

    Sports Development Program

    PARENT CONSENT
    THIS IS TO CERTIFY that I am the Parent/Guardian of
    Athlete_____________________________. That I am allowing him/her to participate in the
    __________________which will be held on ____________________________ at ________________ and
    I am willing to allow him/her to participate in the succeeding higher meets if ever he/she wins or selected.
    FURTHERMORE, I will not hold the school or its representatives for any untoward incident which
    may befall my son/daughter as long as the cause of such incident beyond their control.

    _________________________ ________________________
    _________________________ Signature over Printed name of
    Mailing Address Parent/Guardian

    _________________________
    Date Signed

    MEDICAL CERTIFICATE
    ____________________
    (Date)

    To Whom It May Concern:

    This is to certify that I have personally examined _________________________________________age


    ______ sex ______ born on ______________ and have found that he/she is physically fit, during the time of
    examination, to join and compete in the RIPRISA Sports Competitions.

    Event: __________________________
    Physical Examination
    Date examined: __________________
    Height: _________________ Weight: ___________________ Blood Pressure___________________________
    Pulse, Resting ____________________________________ Respiratory Rate__________________________
    Other Remarks ____________________________________________________________________________
    ____________________________________________________________________________

    _________________________________
    Physician/Medical Officer
    (Signature over printed name)
    License No.______________________
    PTR. ___________________________
    Date: ___________________________

    A. PERSONAL DATA:
    __________________________________________________________________________________________
    (LAST NAME) (FIRST NAME) (MIDDLE NAME)

    Date of Birth: ____________________________Age: _____________ Place of Birth: ____________________

    Home Address: _____________________________________________________________________________

    School Address: ____________________________________________________________________________

    Name of Parent: __________________________________ _____________________________________


    (Name of Father) (Name of Mother)

    ________________________ _______________________________
    (Signature of Athlete) Chairman-Sports Development

    B. ATHLETIC RECORD:

    Athlete Participation

    __________________________________________________________________________________________
    __________________________________________________________________________________________
    ____________________________________________________________________________________

    RECORD BOOK

    __________________________________________________________________________________________
    Date of Registration: Name of Athlete : Home Address
    : :
    : :
    : :
    __________________________________________________________________________________________

    _________________________
    (Head Coach)

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