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Republic of the Philippines

SURIGAO DEL NORTE STATE UNIVERSITY


Narciso Street, Surigao City

“For Nation’s Greater


Heights”

STUDENT-TEACHERS ASSOCIATION

WAIVER

I, _________________________________ (Name), a ______________________


(Course/Year/Section) student of Surigao Del Norte State University, Surigao City Campus, have hereunto
agreed to undergo the CLASS OBSERVATION within 120 hours under the designated Cooperating School.

It is fully known that I have understood the nature of the event and have signed the same with my
voluntary act and deed. Furthermore, the above-mentioned institution as well as the organizers will not be
liable for any untoward and unavoidable circumstances during the participation of this activity.

Signed this ____day of ________________ 2022 in the City of Surigao, Surigao del Norte,
Philippines.

________________________________
Signature over printed name

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