STUDENT’S COPY

CERTIFICATION OF WAIVER
TO WHOM IT MAY CONCERN:

This is to certify that I am allowing my son/daughter, _________________________

to join the VICTORY PARTY of his/her team, the HEALTH VANGUARDS, in Casa Romana,
San Fabian, Pangasinan, scheduled on September 24, 1PM to September 25, 2PM. It is
understood that my son/daughter shall abide by the rules and regulations that may be
imposed by the faculty in-charge for the welfare and safety of the group. It is further
understood that I fully agree to waive any responsibility on the part of the University and the
faculty-in-charge in case any untoward incident happens to my son/daughter during the
party and all the activities included therein.

Date: _____________________

___________________________
Signature
___________________________
Printed Name of Parent/Guardian

ORGANIZATIONAL COPY

CERTIFICATION OF WAIVER
TO WHOM IT MAY CONCERN:

This is to certify that I am allowing my son/daughter, _________________________

to join the VICTORY PARTY of his/her team, the HEALTH VANGUARDS, in Casa Romana,
San Fabian, Pangasinan, scheduled on September 24, 1PM to September 25, 2PM. It is
understood that my son/daughter shall abide by the rules and regulations that may be
imposed by the faculty in-charge for the welfare and safety of the group. It is further
understood that I fully agree to waive any responsibility on the part of the University and the
faculty-in-charge in case any untoward incident happens to my son/daughter during the
party and all the activities included therein.

Date: _____________________

___________________________
Signature
___________________________
Printed Name of Parent/Guardian