Republic of the Philippines

CITY OF MAKATI
UNIVERSITY OF MAKATI
J. P. Rizal Extension, West Rembo, Makati City
882-0679 • 882-0683 • 882-0681 • 883-1867 • 883-1874

Agreement and Consent Form for Limited Face-to-Face Classes, Internship, Community
Exposure / Immersion, Participation in Sports Competition, and any other In-Campus and
Off-Campus Activities

I, Almira Louise G. Palomaria , a student of the

of the University of Makati (UMak) taking up BS MANAGEMENT ACCOUNTING
hereby voluntarily agree to undertake the following terms and conditions listed herein in
compliance with existing rules, policies, and health and safety protocol for limited face-to-face
classes, internship, community exposure / immersion, participation in sports competition, and any
other in-campus and off-campus activities, to wit:

a. That I am fully aware that only those fully vaccinated students are allowed to join limited
face-to-face classes, internship, community exposure/immersion, participation in sports
competition and any other In-Campus and Off-Campus activities;

b. That I am not a vulnerable individual with uncontrollable health risk, with immunocompromised
state, with comorbidities, or pregnant;

c. That in the event of new IATF resolutions on the conduct of contact / non-contact activities, sports
competition or any other group-based co-curricular or extra-curricular activities, such is deemed
part of the rules that should be observed;

d. That I am fully aware that off-campus activities for the completion of course requirements such as
NSTP, practicum / internship / training / fieldwork, etc. are subject to compliance with the
applicable health and safety protocols herein attached, and the conditions laid down under IATF
resolutions and its succeeding issuances;

e. That I am fully aware that only those students who are registered with PhilHealth either as a
direct or indirect contributor (dependent of a direct contributor) or with equivalent medical
insurance that cover medical expenses related to COVID-19, are allowed to participate in the
limited face-to-face classes, internship, community immersion, and participation in sports
competition or any other off-campus activities;

f. That I shall be compliant with minimum public health standards in the classrooms, laboratories,
libraries, cafeterias, comfort rooms or other communal areas;

g. That in line with the University cyclical student shifting system, I am aware that students shall only
be in the campus during their designated schedule;

h. That I am fully aware of the maximum number of students present inside the classrooms,
laboratories, libraries, cafeterias, comfort rooms, and other facilities which will be used for limited
face-to-face classes, internship, community immersion, participation in sports competition and
any other In-Campus and Off-Campus Activities following the 1.5 meters physical distance and
IATF-permitted maximum venue capacity;

i. That I am fully aware that students are required to bring their own personal hygiene kits which
shall contain among others: alcohol or hand sanitizer, cleansing wipes/tissue paper/toilet
paper/hand towel, extra face mask, and hand soap;

j. That I shall stay home when not feeling well or have COVID-19 symptoms and shall report my
condition to my Professor;

k. That I shall follow one entry, one exit per day policy for students and that I shall not be allowed to
leave the campus premises between classes;

l. That I shall be transparent in declaring my health conditions and Covid-19 vaccination status
including those of my family members;

m. That the limited face-to-face classes, internship, community immersion, and any other in-campus
and off-campus activities or training is an academic requirement for graduation;

n. That I shall abide by the rules and regulations of both UMak and the host training establishment,
the partner institutions, the communities or the sports organizers;
 o. That I shall behave and show proper decorum at all times in accordance with the standards set
by UMak and its partner institutions/communities/organizers;

p. That I shall exercise care and due diligence in any task assigned to me under the training
program;

q. That in the event that I receive personal information during my internship, community immersion,
and any other in-campus and off-campus activities as defined in Data Privacy Act of 2012 of the
Republic of the Philippines, I shall ensure full compliance with the provisions of the Act and that
such personal information shall only be used in the performance of my internship tasks;
r. That I shall not in any way hold UMak and the host training establishment, the partner institutions,
the communities or the sports organizers responsible/liable from any accident, sickness or injury
that I may suffer in the course of my participation in the limited face-to-face in-campus and
off-campus activities or training;

s. That I shall be responsible for any and all damage/s to property or injury to third persons resulting
from my intentional or negligent acts while undergoing training or if my non-compliance results to
an accident, injury, or loss of belongings;
t. That violation of any provisions of this Agreement and other policies governing limited
face-to-face classes, internship, community immersion, participation in sports competition, and
any other in-campus and off-campus activities shall mean termination from the program;

u. That in consideration of my participation in limited face-to-face classes, internship, community

immersion, sports competition, and any other in-campus and off-campus activities, I hereby
release or discharge University of Makati, its officers, employees and agents from any and all
liabilities or claims, resulting from my personal injury, accident or illness, and property loss arising
from my participation;

v. That my participation in the limited face-to-face classes, internship, community immersion, sports
competition, and any other in-campus and off-campus activities carries with it certain risks which
cannot be eliminated regardless of the diligence exercised to avoid injuries inherent in such
activities, such as, but not limited to, physical activities, use of hazardous substances, operating
machinery and use of common tools and equipment, etc.

w. That I agree to hold University of Makati its officers, employees and agents free and harmless
from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities,
including attorney’s fees and costs of suit brought as a result of my participation in the limited
face-to-face classes, internship, community immersion, sports competition, and any other
in-campus and off-campus activities;

x. That I have read this agreement and fully understood its terms and conditions acknowledging that
we are signing it freely and voluntarily.

Signed on this ___25__ day of APRIL 2023 at UNIVERSITY OF MAKATI

Signature Over Printed Name of Student

With our Consent and Approval:

Signature Over Printed Name of Parent/Guardian Signature Over Printed Name of School Representative
 HEALTH AND SAFETY PROTOCOL FOR LIMITED FACE TO FACE

Dear UMak Students:

We are happy to have you back in school very soon but since the Coronavirus Disease (COVID-19)
pandemic is far from over, we need to continue doing our part in observing health and precautionary
measures to prevent, control, and mitigate the pandemic. While you were away, we have done our best
to help ensure that the entire school campus is disinfected and virus-free and we need to keep it that way.

Following the advisories and recommendations from the Department of Health (DOH) and the
Inter-Agency Task Force (IATF) for the Management of Emerging Infectious Disease, below are the
required health and safety precautionary measures that you are expected to follow in the conduct of
limited face-to-face classes:

BEFORE GOING TO SCHOOL

1. Check your temperature;

2. Stay home if:
a. Your temperature reaches 37.5 degrees Celsius and/or you have cough, colds and other
respiratory symptoms;
b. You have relevant history of travel or COVID-19 exposure within the last 14 days;
3. Prepare your health and hygiene pack, such as face mask, soap, alcohol, hand sanitizer, tissue
or toilet paper, paper towel, wipes, napkins, etc., and bring them to school for your personal use
while inside the school campus;
4. Prepare and bring food (baon) for your consumption while inside the school campus, whenever
possible;
5. Prepare and bring eating and drinking utensils as part of our No to Single-Use Plastic
campaign, (lunch kit, plate, spoon and fork, water jug, beverage bottle, mug, glass, etc.) for your
personal use while inside the school campus;
6. For those with Smart Phone, download a QR Code Scanner App to be used in accessing online
the Health Declaration Form that you will accomplish upon entry to the university. Be sure you
have mobile data while scanning the QR Code and accomplishing the form;

UPON ENTERING THE SCHOOL

1. Strictly follow the “No Face Mask, No Entry” policy;

2. Using your Smart Phone with mobile data, scan the QR Code posted at the entrance gate to
access online the Health Declaration Form to be accomplished. For those without Smart Phone,
you are required to accomplish in writing the Health Declaration Form available at the Guard
House upon entry;
3. Observe physical distancing of at least 1.5 meters apart;
4. Using a personal vehicle such as bicycle, motorcycle, or e-scooter to gain entry into the campus
is allowed, but back-riding is not permitted;
5. Follow the designated entry point at all gateways of the university, keeping always to the right
side in a single formation (Likewise, follow the designated exit point at all gateways, keeping
always to the right side in a single formation);
6. Submit to the mandatory temperature check and if your temperature reaches 37.5 degrees
Celsius and/or you have cough, colds and other respiratory symptoms, you will be asked to go
home;
7. Record your temperature on your notebook each time you are checked, for proper monitoring;

WHILE INSIDE THE SCHOOL

1. Wear face mask at all times, except when eating or drinking;

2. Observe physical distancing of at least 1.5 meters apart, at all times;
3. Follow all visual reminders on safety policies;
4. Comply with affixed markers for sitting, waiting, queuing, and the like in public spaces;
5. Limit prolonged face-to-face interactions between and among students for academic or
school-related matters, hence no prolonged trivial chats or dialogues;
6. Keep informal academic or school-related student meetings and activities needing physical
presence and face-to-face interaction up to a maximum of 10 participants and one-hour duration;
7. Avoid sharing of school supplies, devices and gadgets, food and drinks, eating and drinking
utensils, personal possessions and other items to prevent possible contamination;
8. Cover your mouth and nose with tissue or toilet paper, paper towel, or with flexed elbow, when
coughing or sneezing;
9. Dispose used hygiene paper products immediately and properly, by disinfecting the used tissue
or toilet paper, paper towel, etc. prior to disposal and throwing them in designated garbage bins;
10. Wash or disinfect hands and arms (up to your elbows) frequently with soap and safe water or with
alcohol-based hand sanitizer or wipes;
 11. Avoid unnecessarily touching surfaces and your face, eyes, mouth, and nose with your bare
hands;

USE OF SCHOOL FACILITIES

1. General Guidelines
a. Wear face mask at all times, except when eating or drinking;
b. Observe physical distancing of at least 1.5 meters apart or two (2) seats apart or
according to the affixed markers, as may be applicable, at all times;
c. Follow maximum number of persons allowed and maximum duration of activity inside the
facility, as indicated below and/or at the entrance of the facility;
d. Limit use for daily essential activities and transactions, course-required activities and
special projects, or Management-approved co-curricular projects and events, as may be
applicable;
e. Eat only inside the canteen/cafeteria and designated dining areas;
f. Keep clean and orderly at all times;
g. Plan your day-to-day activities well to regulate your movements within assigned
classrooms and relevant facilities and service areas to fulfill your curricular and
co-curricular obligations, while minimizing physical contact with other persons;
2. Multi-Media Rooms 507 and 1012 located at the Health and Physical Science Building
a. In the event that mass gatherings shall be allowed by the IATF, use only for
course-required activities and special projects or Management-approved co-curricular
projects and events that may or may not be facilitated by a faculty member or
administrative head;
b. Comply with the maximum capacity (based on allowable number per alert level excluding
faculty or administrative head) at a time and maximum duration of three hours;
c. Observe physical distancing of at least two (2) seats apart;
d. Pre-arrange live video stream using available LED screens inside the campus or through
social media for those audiences who cannot physically attend the activity or event, if
necessary;
3. Toilets
a. Except for emergencies, comply with the maximum capacity of five users (excluding utility
staff) at a time and maximum duration of 15 minutes per user;
b. Observe physical distancing of at least 1.5 meters apart;
4. Canteen/Cafeteria located at the Administration Building and the Health and Physical Science
Building
a. Comply with the maximum capacity of (based on allowable number per alert level
excluding cafeteria personnel and utility staff) at a time and maximum duration of 30
minutes per diner for both purchase and consumption of your meal;
b. Observe physical distancing of at least 1.5 meters apart;
c. Bring food (baon) for your consumption to avoid queuing and waiting when buying food at
the Administration Building Cafeteria, whenever possible;
d. Use your own eating and drinking utensils (lunch kit, plate, spoon and fork, water jug,
beverage bottle, mug, glass, etc.) for dining, whenever possible;
e. Avoid sharing of food and drinks, eating and drinking utensils to avoid possible
contamination;

We anticipate that this protocol will be strictly followed by all students and we urge you to encourage your
co-students to adhere to all of the above measures. Any serious violation of this safety protocol shall be
dealt with accordingly.

Please understand that while some regulations may seem restrictive, we only have your best interests at
heart to foster a safe, worry-free, and conducive learning environment as we all face the “new normal” in
our university.

Thank you very much for your cooperation.