Republic of the Philippines

Department of Education
Division of Cebu City, ND 5
S.Y. 2018 – 2019
REGINO MERCADO NIGHT HIGH SCHOOL
Panganiban Street, Cebu City
SENIOR HIGH SCHOOL DEPARTMENT

WAIVER

I, ______________________________, Filipino of legal age, parent / guardian of

_______________________, a Senior High School student of REGINO MERCADO NIGHT
HIGH SCHOOL, ____ years old.

That I hereby consent to the participation of my son / daughter in the Work Immersion in
ALEMAR BUDGETEL, which number of hours rendered will be changed and extended to
six (6) hours form four (4) daily starting March 25, 2019. I also bind myself not to hold the
management from any liability for such injury or damage that my son / daughter might suffer
resulting from any incident that occur beyond control during the period of his / her Work
Immersion Program.

That further I voluntary reannounce and waive my right to demand any monetary consideration
during the said Work Immersion Program.

SUBSCIRBE AND SWORN TO BEFORE me this ____ day of March, 2019, at Cebu City,
Philippines.

___________________________ ___________________________
Name and Signature of Parent Name and Signature of Student

___________________________ ARTHUR P. LEGASPINA

Teacher Senior High School Focal Person