Maryknoll College of Panabo, Inc.

(Formerly Maryknoll High School of Panabo, Inc.)

National Highway, Brgy. Sto. Niño, 8105 Panabo City
Tel. No. (084) 823 – 5265
PAASCU Accredited School Level I

PARENTS/GUARDIANS WAIVER
NAME OF PARENT: __________ Margie G. Aragon_______________

ADDRESS: _____ Prk. Dugso San Pedro ,Panabo City______

NAME OF STUDENT: _ Arianne Mae G. Aragon ___________

TRAINING/COURSE: ______Information Communication Technology_

TRAINING LOCATION: _______________L_______________________

TRAINING DURATION: ________________ ______________

I, the aforenamed parent/guardian of the aforesaid student, of legal age, after

having been duly sworn to accordance with the law depose and state that:

1 I am legitimate parent or legal guardian of the aforenamed student, the next-of-kin

with legal custody and who is supporting said student through his/her studies and
basic needs;
2 As a requirement for the aforesaid course, I hereby approve and voluntary agree to
the participation of the said student to the work immersion to be conducted at the
aforestated location and duration;
3 I have fully considered the educational and training benefits of participation in such
work immersion with the understanding that every precaution shall be taken by the
MCPI management, employees or their agents to ensure the safety of their students;
4 I am aware that the MCPI has secured the necessary accident insurance for the
students in this training;
5 I however also understand that MCPI, its management, employees or agents shall
not be held liable for any untoward incident that may happen beyond their control or
arising from force majeure and undertake to inhibit from filing any criminal, civil or
administrative action against MCPI, its management, employees or agents, forever
holding them harmless and free from liability should such untoward incidents beyond
their control ever occur.

IN WITNESS WHEREOF, I hereby set my hands this _______________at Panabo

City, Davao del Norte, Philippines.

___________ Margie G. Aragon ____________

SIGNATURE ABOVE PRINTED NAME OF PARENT/LEGAL GUARDIAN
AFFIANT
ID ____________ ID# __________________

Republic of the Philippines }

Province of Davao del Norte }s.s.
City of Panabo }

SUBSCRIBED AND SWORN TO before me this _____________________ at Panabo City, Davao del Norte,
Philippines. Affiant exhibited to me the IDs stated as competent proof of identity.

Doc. No.: ___;

Page No.: ___;
Book No.: ___;

Series of 2019
 Maryknoll College of Panabo, Inc.
(Formerly Maryknoll High School of Panabo, Inc.)
National Highway, Brgy. Sto. Niño, 8105 Panabo City
Tel. No. (084) 823 – 5265
PAASCU Accredited School Level I

STUDENT WAIVER
NAME OF STUDENT: _________ Arianne Mae G. Aragon __________

HOME ADDRESS: ___ Prk. Dugso San Pedro ,Panabo City _______

SEX/BIRTHDATE: _______ Female / March 18, 2002___________

TRAINING/COURSE: ____ Information Communication Technology __

TRAINING LOCATION: __________LGU Panabo___________________

TRAINING DURATION: _____________80 Hours ________________

I, the aforenamed student, child/minor, after having been duly sworn to accordance
with the law depose and state that:

1 I am enrolled in the aforesaid training course;

2 I intend to participate in the work immersion to be conducted at the aforestated
location and duration;
3 I promise and undertake to exercise maximum caution and safety, to take diligent
care of my person and belongings and shall not participate in any risk-taking
behavior nor endanger myself, equipment or facilities under my care;
4 I undertake to cooperate and participate in all activities and measures undertaken by
the MCPI management, employees or their agents to ensure my safety and that of
the other students;
5 I understand that MCPI, its management, employees or agents shall not be held
liable for any untoward incident that may happen beyond their control, or, due to
force majeure and undertake to inhibit from filing any criminal, civil or administrative
action against MCPI, its management, employees or agents, forever holding them
harmless and free from liability should such untoward incidents beyond their control
ever occur.

IN WITNESS WHEREOF, I hereby set my hands this _______________at Panabo

City, Davao del Norte, Philippines.

_______Arianne Mae G. Aragon______

SIGNATURE ABOVE PRINTED NAME OF STUDENT
AFFIANT
MPCI ID # ___________

Republic of the Philippines }

Province of Davao del Norte }s.s.
City of Panabo }

SUBSCRIBED AND SWORN TO before me this _____________________ at Panabo City, Davao del Norte,
Philippines. Affiant exhibited to me the MCPI ID as competent proof of identity.

Doc. No.: ___;

Page No.: ___;
Book No.: ___;

Series of 2019