I ________________________________ wish to participate in the Team Building Activity of

Gandara District Hospital, which will be held on April 13-14, 2023 in Malajog Leisure Park,
Brgy Malajog, Calbayog City.
I acknowledge that the management will provide free transportation to and from the venue for
all the participants. I understand that certain risks are inherent in travel if I use my own
Motorcycle as means of transportation to the said activity. These risks are not limited to personal
injury and property damage. I understand that there may be a great variety of other risks not
known or reasonably foreseeable.
I acknowledge that Gandara District Hospital is not responsible for any harm that might occur.

I fully release and discharge Gandara District Hospital, officers, and its employees from all
liability in connection with my decision to use my own Motorcycle during the activity.

Signature

Date