REPUBLIC OF THE PHILIPPINES )

PROVINCE OF LAGUNA )
CITY OF ) S.S.

AFFIDAVIT OF CONSENT

I, <NAME>, of legal age, parent of <CHILD>, of legal age, and resident of

<ADDRESS>, after having been duly sworn to in accordance with law, do hereby
depose and state:

1. That I am giving my full consent and authority to my son <CHILD> to go

on a practicum (on-the-job training) for a minimum of one (1) year at
Archipelago with company address 2/M Tomas F. Gimenez Sr., 4 th Floor,
Unioil Bldg., MBP, Ayala Alabang, in partial fulfillment of the
requirements for the degree in Bachelor of Science in Marine
Transportation.

2. It is understood that he abides by the rules and regulations that may be

imposed by the Supervisor/Staff-in-Charge for his welfare and safety.

3. I fully agree to waive any responsibility on the part of University of

Antique, Archipelago, and/or the representative/s, in case of any
untoward incident that may happen to my son during the duration of the
practicum.

Affiant further sayeth naught.

IN WITNESS WHEREOF, I have hereunto set my hand this 20th day of October
2018 at San Pedro, Laguna.

_______________________
<NAME>
Affiant

SUBSCRIBED AND SWORN to before me this 20th day of October at __________,

Laguna.

Doc. No.: _______

Page No.: _______
Book No.: _______
Series of 2018