Republic of the Philippines)

City of Iligan )S.S

AFFIDAVIT OF WAIVER
I, ________________________, _____ years old, single Filipino and a resident of
________________________ after having been duly sworn to an oath in accordance with
law, hereby depose and say:

1. That I am a grade 12 senior high student of ILIGAN CITY NATIONAL HIGH SCHOOL taking
up ___________________________;

2. That one of the requirements is to undergo 240_ hours on-the-job training (OJT) at
_____________________________ establishments to apply knowledge and skills in
___________________ , from May 02, 2023 to June 09, 2023

3. That as an OJT, I am fully aware that no employee-employer existed and that not entitled
to any salary whatsoever relating to the working hours rendered in the said office;

4. That I renounce and waive any claim against the company/agency/ICNHS for any injury or
loss that I may incur in the performance of my duties and responsibilities in the
company/agency/ICNHS;

5. That I am executing this affidavit to attest the veracity and truthfulness of the foregoing
statements and for whatever legal purpose it may serve.

IN WITNESS WHEREOF, I here unto set my hand this ____ day of ___________, 2023
at Iligan City Philippines.

ATTESTED BY: Maria Christina M. Mina __________________

Immersion Coordinator Affiant

With Parental Consent:

_______________ _______________
Father Mother

SUBSCRIBED AND SWORN to before me this _____ day of ___________, 2023 at Iligan City
Philippines.

_______________________
Administering Officer