Republic of the Philippines

BATANGAS STATE UNIVERSITY

Alangilan, Batangas City

PARENTAL CONSENT
I hereby allow my son/daughter _________________ to join the _________________of the
_________________ on _________________.

WAIVER AGREEMENT
To whom it may concern,
I __________________________________, _________________
(Name in Print) (Year-Section)

do hereby agree and bind myself to the following:

1. To free and absolve _________________ from any and all liabilities, whatsoever, for any loss,
damage, or injury which I may suffer due to whatever cause or causes during the
_________________ in connection with my course or extra curricular activities.
2. To free and absolve _________________ from and to assume full responsibilities for, and said
loss, damage, or injury which may cause to third person and/or property during the said
_________________.
NOTE: THE FIELD TRIP COSTS P2,100.00

_______________________ _______________________
Parent/Guardian Student’s Signature

_______________________ Engr. DIVINA GRACIA RONQUILLO

Instructor Department Chairman

Engr. TIRSO A. RONQUILLO

Dean

Republic of the Philippines

BATANGAS STATE UNIVERSITY
Alangilan, Batangas City

PARENTAL CONSENT
I hereby allow my son/daughter _________________ to join the _________________of the
_________________ on _________________.

WAIVER AGREEMENT
To whom it may concern,
I __________________________________, _________________
(Name in Print) (Year-Section)

do hereby agree and bind myself to the following:

1. To free and absolve _________________ from any and all liabilities, whatsoever, for any loss,
damage, or injury which I may suffer due to whatever cause or causes during the
_________________ in connection with my course or extra curricular activities.
2. To free and absolve _________________ from and to assume full responsibilities for, and said
loss, damage, or injury which may cause to third person and/or property during the said
_________________.
NOTE: THE FIELD TRIP COSTS P2,100.00

_______________________ _______________________
Parent/Guardian Student’s Signature

_______________________ Engr. DIVINA GRACIA RONQUILLO

Instructor Department Chairman

Engr. TIRSO A. RONQUILLO

Dean