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Republic of the Philippines

Province of Batangas
CITY OF TANAUAN

OFFICE OF THE SANGGUNIANG KABATAAN FEDERATION


TANAUANCityofColors
Website: www.tanauancity.gov.ph Email: skfedtanauan@yahoo.com Tel no: (043) 728-9852 (loc)1125

WAIVER AND RELEASE FROM LIABILITY

I ___________________________ (hereinafter called “The Participant ) hereby agree to hold the


La Consolacion College Tanauan their teacher, students or any other person acting on their behalf
, harmless from all actions, claims or demands of every type and character arising out of or in
connection with the participation in the Youth Assembly Symposium with the theme
“TRANSFORMING EDUCATION” as part of the celebration of the Province Linggo ng Kabataan.

Furthermore, I agree that should I not have adequate coverage to cover any cost or expenses
that result from personal injury suffered by the participant in connection with any activities
associated with the Tournament, I will either acquire such coverage or be personally liable for
any expenses incurred there from.

In emergency cases, I hereby grant permission to Sangguniang Kabataan Federation office official
and staff or any other person acting on their behalf to seek medical care from any licensed
physician, hospital, or medical clinic for the participant named here in at such times for the
duration of 6:00 in the morning to 6:00 in the evening of the program, including the period
required to travel to and from those activities. The undersigned hereby waives releases,
absolves, indemnifies and agrees to hold harmless the Sangguniang Kabataan officials and staff,
organizer, supervisors, participants and persons transporting the participants to and from
activities, for any claims, demands or injuries to the participants.

___________________________________
Participant’s Signature over printed name

__________________________________________
Parent or Guardian / Signature over printed name

Contact Information (Very Important)

Parent / Guardian Name: _________________________________________________


Current Address: ________________________________________________________
Contact No.:______________

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