DECLARATION/ UNDERTAKING FROM THE STUDENT

NAME OF DELEGATE AREA AND DISTRICT

SCHOOL

ADDRESS

MOBILE NUMBER

EMERGENCY CONTACT PERSON

MOBILE NUMBER OF CONTACT PERSON

I, (______________________), hereby express my intention to join DAMGO: Area C Assembly 2019,

organized by the United Architects of the Philippines – Student Auxiliary Area C to be held on November
15 – 17, 2019 at Nature's Village Resort, Talisay City, Negros Occidental.

In connection with the above mentioned activity, I declare that:

I take it as my responsibility to take the necessary precaution or care of avoiding or getting involved in any
incident that would cause slight, serious or mortal injury upon my person or results in the loss or damage
to my property and that of another person.

I understand that I am not to engage in any behavior that could or may lead to any incident or could result
to loss or damage to property, injury to myself or other person(s).

I understand that it is my responsibility to fully ascertain, if necessary with the help of a medical professional,
my physical and mental fitness to join this activity.

I have properly informed and secured the consent of my parents or the person(s) exercising parental
authority over my person concerning the nature of the activity which I am joining.

I am fully convinced that the organization has exercised sufficient diligence and care in the preparation and
implementation of this activity.

I understand that the United Architects of the Philippines Student Auxiliary is not liable to any unexpected
circumstances that may happen during the activity.

Delegate’s printed name and signature:

Date:
 DECLARATION BY PARENT/GUARDIAN

I (______________________), hereby fully endorse the above undertaking/declaration given by my

child/ward. And I will endeavour to induce my child/ward to do his/her best to observe the above stated
undertaking.

Parent/guardians printed name and signature:

Date: