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Office

of Student Affairs and Services


Student Organizations and Activities Unit

WAIVER

I am allowing my son/ daughter Johna Lou D. Dayapan to join the organization


namely Exercise and Sports Society, this Academic Year 2022-2023.

I understand that the authorities of the Office of Student Affairs and Services of the
Southern Luzon State University exercise the necessary safety precautions in this activity.

In consideration of the benefits to be derived from his/her membership to the said


group, I expressly waive any and all claims against the administration or the faculty
adviser of the organization on account of unforeseen incident or injury that my
son/daughter might incur in joining the organization.

CAROLINA D. DAYAPAN September 23, 2022


Signature over printed name of Parents/Guardian Date

JOHNA LOU D. DAYAPAN September 23, 2022


Signature over printed name of Student Date

AA-OSAS-1.01F3, Rev.2

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