University of the Philippines

College of Human Kinetics

Expense Acknowledgement and Liability Waiver Form

I have been made fully aware of the Out-Of-Pocket expenses incurred during participation in the
Campouts required to comply fully with the requirements of this course. These expenses were indicated
clearly in the CRS at the point of my class enrollment and explained in detail at the start of course by the
Class Instructor and/or his/her designated alternate.

I further attest that I have been given the option and opportunity to transfer to another PE Course
that does not require finance and expenditure should I have decided to do so for any reason whatsoever
without any adverse consequences on or before the last day of enrollment set by the University of the
Philippines.

I therefore agree to assume all Out-Of-Pocket expenses incurred as a result of my willful

participation in the abovementioned Campouts. I further agree to hold the UP CHK or anyone acting on
its behalf free from any responsibility or liability for these incurred expenses.

(Signature over Printed Name, Date and Student #)

(Signature of Parent/Guardian over Printed Name and Date if student is under 18 years of age)