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Philippine Society of Youth Science Clubs, Inc
2011 National Youth Science Technology and Environment Summer Camp
Sarabia Manor Hotel & Convention Center,
101 General Luna St., lilo Gty
‘April 7-10, 2011
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Home Addresses:
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PRINICIPAL’S ENDORSEMENT
I certify that isa bona fide
studentof _andis
one of the school's official delegates to the 2011 National
‘Youth Science Technology and Environment Summer Camp.
Signature over printed name of Principal
MEDICAL CERTIFICATE
I heraby certify that i have examined
‘and found him/her physically eto
join the 2011 Wational Youth Science Technology and
Environment Summer Camp.
Signature over printed name of Physician
PARENTAL CONSENT.
| hereby allow my son/daughter to participatein the2012
NationalYouth Science Technelogy and Environment
Summer Camp. | will not hold the organizers responsible
‘to any accident that may happen beyond their control
Signature over printed name of Parent
AGREEMENT
I hereby agree to the rules and regulations set by the
organizers and that | will be held responsible for any loss or
damage of the venue's facilities
Signature over printed name of Adviser
FOOD RESTRICTIONS: SPECIAL MEDICATION/S
‘NEEDED:
NYSTESC Secretariat
Philippine Society of Youth Science Clube
Unit 703 West Mansions Cancaminiam, Zamboanga St
Brgy. Nayang Kanluran, Quezon Cty 1104
‘Telephone: (02)399-4984 | Telefax: (02)932-8151
E-mail: mail@psysc org
JOINING COMPETITONS? [heck al tht amps)
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Diratcree
(oleae nferta te ctachea Comparative Sir size Chart Heo please note thet
shireszes wil ony be guaranteed if you submit our Registration formson er
before narch 2011)
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