LIABILITY WAIVER

I am fully aware of the duties and responsibilities I will undertake through the Work Immersion Program
with cooperating industry through the request of Muntinlupa National High School-main:

I recognized the authority of my cooperating industry which I may be place and submit to all the rules
and regulations that may be imposed upon myself to do the following duties.

I renounce and waive any claim against the cooperating industry and the Muntinlupa National High
School-main for injury that may sustain/loss that suffer, personal/financial in the performance of duties
/ function.

Name of Student: ____________________________________

Signature: __________________________________________
Date: ______________________________________________

PARENTAL/GUARDIAN’S CONSENT

And I, minor’s parent of and/or legal guardian, allow my son/daughter to undergo work immersion for a
minimum of 80 hours starting ______________________ until_________________________
At _________________________ in partial fulfilment of the requirements for Grade 12 Student.

It is understand that she/he abides by the rules and regulations that may be imposed by the supervisor/
staff-in-charge for his/her welfare safety.

I fully agree to waive any responsibilities on the part of Muntinlupa National High School - Main, in case
of any untoward incident that may happen to my son/daughter during the duration of WORK
IMMERSION.

NAME OF PARENT/LEGAL GUARDIAN:____________________________________

SIGNATURE:______________________

DATE:___________________________