Date: ________________
________________________
________________________
________________________
Re : W A I V E R
Sir / Madam:
The undersigned is the parent / guardian of ___________________________ my son /daughter of / war, and presently enrolled at the High School (PTMSMNHS – Caminawit Extension) San Jose, Occidental Mindoro for the Academic Year 2011 – 2012.
I hereby entrust ______________________________ to the proper care and custody of PTMSMNHS Administrator in preparation of 9th Division Skill Development & Competition and other similar activities hereby my child / ward actively participates, and thus I expressly absolve the PTMSMNHS and its officials, officer, faculty members and employees from all responsibility and liability for any and all kinds of harm of injury whether slight, serious or fatal which my aforenamed child / ward may suffer during said 9th Division Skill Development & Competition, etc., and I hereby waive all claims in connection therewith against PTMSMNHS officials, officers, faculty members and its employees.
Activity __________________ Date ____________________
___________________________
Father / Mother / Guardian
I hereby attest / certify that the above signature is the true and genuine signature of my father / mother / guardian _______________________________.
__________________________
Students Signature
Noted:
FRENCILLE Q. BRABONGA
BSP / GSP Coordinator
ADELINA D. ACOSTA
HT-IV / Teacher-In-Charge
