COLLEGE

ENGINEERING

OF

San Nicolas de Tolentino Bldg, Colegio San Agustin, B S Aquino Dr, Bacolod City 6100, Philippines
Tel (034) 434-2471 (75) local 150, Fax (034) 433-9187

WAIVER
TO WHOM IT MAY CONCERN:
Consent is hereby given for my son/daughter
to
undergo
On-The-Job
Training
at
located
at
_______________________________________________________________
from
____________ to ____________in partial fulfillment of the requirements for the degree BSChE /
BSME / BSChem / BSECE / BSCoE. Cognizant of the need to expose students to
industries/activities related to their field of study and its importance to their future professional
practice, we fully support this training activity.
Furthermore, we are waiving claim from the College of Engineering, Colegio San
Agustin-Bacolod,
and the Instructor for compensation or liability,
civil or criminal, for any and all damages, injuries or untoward incidents that may happen to our
son/daughter during the course of his/her training.
Given this _______ day of _____________________, 2015 in the City/Municipality of
___________________________, Province of __________________________, Philippines.

______________________________
(Signature over Printed Name)

Parent/Guardian
______________________________
(Signature over Printed Name)

Student