PARENT’S WAIVER

The College of Criminal Justice Education, Negros Oriental State University, Dumaguete City
has requested this waiver in connection with the subject First Aid and Water Survival (DEFTAC
200) Program effective this 1st Semester of School year 2019-2020 and which is accepted and
confirmed.

The Student

Complete Name Course and Year

Together with his/her parent or judicially approved guardian acknowledge that the permission be
granted to him/her as made subject to the condition, which he/she hereby accepts and agrees so
that the University will not assume any responsibility whatsoever for any injury or accident
which may happen to him/her outside the premises of the project area during the period of the
said program. It is understand that the student will pay for the entrance fee of the Aqua Center
with the amount of PHP50.00 per session.

This waiver will be in effect for the duration of to

Done this day of in Dumaguete City.

Signature of the Student Signature over Printed Name

of the Parent or Guadian

GALO A. ALVIOLA

DEFTAC Instructor

JOSE RENE A. CEPE Ph. D

Dean, College of Criminal Justice Education