WAIVER OF RESPONSIBILITY

Passenger name:
Address:
Nationality:
VN
VN
VN

Passport No.
Date
Date
Date

From
From
From

To
To
To

I undersigned the above-named passenger (hereinafter referred to as Passenger)/the parent/guardian of

the above named passenger (hereinafter referred to as Passenger), being fully aware of the contents of
the tariff rules of Vietnam Airlines (hereinafter referred to as VNA), hereby agree to release and
discharge VNA , their agents, officers and employees from any and all liability which may be
consequential as the result of the travel and/or carriage by VNA as specified above due to the conditions
specified below and/or any possible consequence thereof. Further, agree to indemnity and hold VNA any
and all action, claims and proceeding against VNA by any third party or parties including all costs, losses,
damages, charges and expenses incidental thereto which may be suffered by VNA as the result of the
travel and/or carriage by VNA specified above due to condition specified below and any possible
consequence thereof.
(Specify the condition below with a mark X
1. Improper packing and/or the nature of the contents of the Passengers baggage, which may
not be fit to normal handling of carriage by air.
Baggage tag No: ..............................................
2. Present mental of physical state of Passenger which may involve any hazard of risk to
himself (herself) or others.
4. Passenger pet and animal(s) which may, according to its (their) physical conditions of health
state, be improper to be carried by and thus may cause hazard or risk to itself (themselves) or
others.
Kinds of animal: ............................................................................................................................
5. Other conditions:
Handling Agents Signature/Station

Signature:
Passenger/the parent/guardian