OFFICE FOR STUDENT AFFAIRS

900 San Marcelino St, Ermita, Manila, 1000 Metro Manila

Telefax: (522-0016, Trunk Link (63)524 2011, Loc 243

CONSENT AND RELEASE

There is an inherent risk of harm or injury in any participation to the __________________

(Activity)
to be held at ________________, ______________, _______________.
(Venue/Place) (Date) (Inclusive Time)

These risks and danger may be caused by our own actions or inaction participating in the
same activity, or the condition in which the activity takes place.

There may be other risks either not known by ours or not readily foreseeable at this time,
and WE FULLY ACCEPT AND ASSUME ALL SUCH RISKS. We may come across as
a result of our participation in the said activity.

We hereby assume all risks and to release, in advance, and to waive, discharge and hold
harmless ADAMSON UNIVERSITY and its officers, agents and employees from any and
all claims for injury or damages which we may have or which may hereafter accrue to
ours as a result of our participation in the said activity.

We understand that the terms and provisions of this documents are severable. If, for our
reason, on or more terms of this documents are unenforceable, illegal or in conflict with
any law governing this document, the validity of the remaining portions of this document
shall not be affected.

The following students fully understand the statement of the consequences of their
actions.

Maria Isabelle Sancho Dianne Kristelle Jumalon

Student Student

Armstone Joachim Tamayo Joanna Marie Reynoso

Student Student

Mr. Renz Patrick Santos

Supply Chain Management Professor