OUR LADY OF THE PILLAR COLLEGE- SAN MANUEL, INC.

San Manuel, Isabela

WAIVER

We__________________________________________________________ who are legal parents /guardian of

______________________________________ residing at _________________, Aurora, do hereby certify that we give
our full consent for him/ her to join the TRY-OUT and Practice OF BASKETBALL on Thursday, July 25, 2016 at
OLPC- SMI.

I further agree to assume the responsibility of seeing that my son/ daughter cooperates and conforms to the
fullest with the directions and instructions of the SCHOOL and that I hereby free them from any responsibility for
any untoward incident arising from this activity thereby waiving any future claim for damages against the
organizers, provided however, that the damage or injury incurred is not directly attributable to the negligence
of the authorities themselves.

__________________________________ ________________________
Signature of Parents, (Signature over Printed name) Contact Number

ROSILLIO P. REPOLLO ROMEO YDIA JR.

Sports Club Adviser SPS Officer

MARISSA F. PRUDENCIO, Ph.D SAMUEL C. GAMMAD, Ph. D

Principal Campus Director

OUR LADY OF THE PILLAR COLLEGE- SAN MANUEL, INC.

San Manuel, Isabela

WAIVER

We__________________________________________________________ who are legal parents /guardian of

______________________________________ residing at _________________, Aurora, do hereby certify that we give
our full consent for him/ her to join the PRACTICE AND TRY-OUT OF BASKETBALL on Thursday, July 25, 2016 at
OLPC- SMI.

I further agree to assume the responsibility of seeing that my son/ daughter cooperates and conforms to the
fullest with the directions and instructions of the SCHOOL and that I hereby free them from any responsibility for
any untoward incident arising from this activity thereby waiving any future claim for damages against the
organizers, provided however, that the damage or injury incurred is not directly attributable to the negligence
of the authorities themselves.

__________________________________ ________________________
Signature of Parents, (Signature over Printed name) Contact Number

ROSILLIO P. REPOLLO ROMEO YDIA JR.

Sports Club Adviser SPS Officer

MARISSA F. PRUDENCIO, Ph.D SAMUEL C. GAMMAD, Ph. D

Principal Campus Director
Schedule of Practice

Every Thursday and Friday

at exactly 4:30 to 5:30 pm.