Student Waiver

                                                                             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 9^th 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 9^th 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