PALAWAN STATE UNIVERSITY

Brooke’s Point Campus

Brooke’s Point, Palawan

DEPARTMENT OF CRIMINOLOGY

This is to certify that I/we am allowing our son/ daughter _________________________________to join in the
upcoming RECEPTION RITES FOR BS-CRIMINOLOGY STUDENTS
on_________________________________at Palawan State University- Brooke’s Point Campus, Brooke’s
Point Palawan. The ultimate goal of this activity is to welcome them as part of the growing family of the
Department of Criminology.
It is understood that ____________________________will follow the policies and guidelines set by the school
(Student’s Name)
and abide by the rules and regulations that may be imposed by the supervisor/staff-in-charge for her/his
welfare and safety.
I fully agree to waive any responsibility on the part of Palawan State University-Brooke’s Point Campus and the
supervisor/staff–in–charge, ROTC Officers in case of any untoward incident that may happen to
__________________________________in the duration of the Reception Rites.
(Student’s Name)

Signature:

Name of Signatory:

Relationship of Signatory to Student:

Date Signed:

______________________________________________________________________________________________________________________
1 .The signature/s in this document must match the signatures of the student’s Parents or Guardian. (Attached the photocopy of the
Parents/Guardian Valid ID w/signature.
2. In the event that a parent cannot sign the waiver form, it must be signed by the legitimate guardian, as evidenced by the letter of guardianship on
file.
3. This document must be dated, signed and submitted within the first day of the training.