Republic of the Philippines

Department of Education
REGION VII – CENTRAL VISAYAS
SCHOOLS DIVISION OF CEBU PROVINCE
DISTRICT OF TUBURAN I
KABKABAN ELEMENTARY SCHOOL
KABKABAN, TUBURAN, CEBU
SCHOOL ID NO. 119810

UNDERTAKING AND WAIVER

(for Lacking Admission Credentials)

KNOW ALL MEN BY THESE PRESENTS:

I,_________________________________________, a Filipino, of legal age, single/married, and
(Name of Parent/Guardian)
A resident of ________________________________________, do hereby depose and say, that:
(Address)

1. I am applying for my child’s enrollment in KABKABAN ELEMENTARY SCHOOL, Brgy.

Kabkaban, Tuburan, Cebu, particularly in ___________________ of academic year 20___-20___;
(Grade Level)

2. I am unable to submit the following credential/s which I fully understand is/are part of the
requirements for enrolment: (please check lacking credentials)
_______ SF9(School Progress Report Card)
_______ Photocopy of PSA-issued Birth Certificate
Others (please specify) _______________________________________________
3. In view of the non-submission of the above-cited admission credentials, my enrolment in Kabkaban
Elementary School is considered “temporary” during the said term pending submission of the
necessary requirements;
4. I hereby promise to submit the lacking credentials identified above to my child’s adviser not later
than ______________________;
(Date)

5. I fully understand and agree that failure to submit the said requirements on or before the promised
date prevents my child from enrolling in the succeeding academic year;
6. I agree that my child will abide by all the rules and regulations of the school as expected of a regular
student;
7. Upon receipt by the school of my child’s documents, I will comply with the recommendations of the
school based on the evaluation of his/her school records;
8. In relation to this unilateral act, I hereby agree that the Kabkaban Elementary School is free from
any liability and that I waive and release Kabkaban Elementary School Faculty Staff from any claim
or action arising there from;
9. That my executing this undertaking and waiver is a free and voluntary act. IN WITNESS
WHEREOF, I hereunto affix my signature this ___________ day of ________________________,
20___ at Brgy.
(Day) (Month)
Kabkaban, Tuburan, Cebu, Philippines.

_________________________________
Student’s Signature over Printed Name

Contact No.: ______________________