PAMPANGA STATE AGRICULTURAL UNIVERSITY

PAC, Magalang, Pampanga

OFFICE OF STUDENT SERVICES AND DEVELOPMENT

Office of Cultural and Performing Arts
PSAU Imago Dei Chorale

I/We _______________________________________________ am/are permitting my/our son/daughter

__________________________________________________ to:

1. Join/Attend performance by invitation at:

A. Magalang, Pampanga
B. San Fernando, Pampanga
C. Other parts of Central Luzon
D. Manila
E. Other part of the Philippines
2. Perform in the Flag Raising Ritual every Monday(6:45 am – 8:00 am)
3. Attend rehearsals of PSAU Imago Dei Chorale every Monday-Thursday(11:00am – 1:00pm)
Friday (7:00am – 4:00pm) depending on the class sched of the member, to be held at Pampanga State
Agricultural University
4. Attend (5:00pm – 6:00pm) of PSAU Imago Dei Chorale rehearsals if necessary to be held at
Pampanga State Agricultural University
5. If necessary attend rehearsals on Saturday/Sunday/Holidays (8:00 am – 4:00 pm) to be held at
Pampanga State Agricultural University
6. Attend & perform in special school programs:
A. Recognition rites
B. Catholic Mass
C. Commercement exercises
D. Ecumenical service/s
7. Attend and perform during Socio-Cultural Night without a fixed date (5:00pm onwards) to be held at
Pampanga State Agricultural University
8. Attend and compete in the CAASUC FESTIVAL 2019 to be held at Don Honorio Ventura State
University
9. Attend the Mass Induction of officers to be held at Pampanga State Agricultural University
10. Perform community services as penalty due to tardiness and absences during rehearsals and
performances
11. Pay for lost Costumes
12. Perform or compete abroad

We_________________________________________and______________________________________
_______________, hold the school free from liabilities from any untoward incidents as may be brought
about by the said activity.

_________________________________________ _______________________________________
(Signature over Printed Name of Parent/Guardian) Student’s Signature over Printed Name

____________________________
Date

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Noted:

RENATO R. SIMBULAN
Musical Art Coordinator

OLIVIA G. DIMALANTA, Ed.D.

Personel-In-Charge/Conductress

FERNAN R. FERNANDEZ , M.A.Ed. D.

Overall Personel-In-Charge
Director, Cultural and Performing Arts

ARNELLO S. VALERIO Ed.D

Director, OSSD/Guidamce, Counseling and Testing Center

Republic of the Philippines )

Province of Pampanga ) s.sMuniciplaity of Magalang )

SUBSCRIBED AND SWORN to before this___th day of _______________ 2019, at

Magalang, Pampanga, by_________________________________________________with Pampanga
State Agricultural University Student ID No._____________________S.Y. 2019-2020, who personally
appeared to me to be the same person who personally the foregoing instrument and acknowledged that
they executred the same.

NOTARY PUBLIC

Doc. No._____;
Page No._____;
Book No._____;
Series of 2019.

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