OJT FORM 1 TRAINING AGREEMENT AND LIABILITY WAIVER

REPUBLIC of the PHLIPPINES

BATANGAS STATE UNIVERSITY
BATANGAS CITY

TRAINING AGREEMENT AND LIABILITY WAIVER

I, Matt Jason B. Mendoza, a student of BATANGAS STATE UNIVERSITY, BATANGAS CITY, hereby
voluntarily agree to undergo On-The-Job Training in any educational institution/industrial firm or
establishment in order to acquire work experience related to the academic training gained from the
College/School of College of Engineering, Architecture and Fine Arts / Batangas State University Main
Campus II under the following terms and conditions:

1. That I shall abide by all the company /school rules and regulation and shall comply with those
imposed for the program; otherwise, I shall be excluded from the further participation;
2. That I shall exercise care and diligence in any task assigned to me;
3. That I shall renounce and waive my claim against the school /industry/establishment for any
injury I suffer personal or pecuniary, in the performance of my duties and function while under
training;
4. That I shall be made answerable for any and all liabilities for damages for property or injury to
third person, which may be occasioned by my intentional or negligent act while in the course of
my training.
5. That I have secured the consent of my parent/guardian on the contents of this waiver as
evidenced by his/her signature below.

Signed on this 5TH day of November, 2015 at Sampaga, Batangas City, Batangas, Philippines.

______Matt Jason B. Mendoza_______

Students Signature over Printed Name

________________________________
Competent Proof of Identity

____________12-50703____________
ID Number

With our consent and approval:

______ZENAIDA B. MENDOZA__________
Parent/Guardians Signature over Printed Name

___________________________________
Competent Proof of Identity

___________________________________
ID Number

SUBSCRIBED AND SWORN TO BEFORE ME this 5th day of November, 2015 at Sampaga, Batangas
City, Batangas, Philippines.