MAKATI SCIENCE TECHNOLOGICAL

INSTITUTE OF SCIENCE AND TECHNOLOGY

4410 ERL Building, Old St. Mesa, Manila

PARENTAL WAIVER AND CONSENT FORM

As the parent or legal guardian of the student named below, I hereby give my full
consent and approval for my son/daughter to participate in PE 3 – First Aid and Water
Safety at PIUS XII Catholic Center, 1175 United Nations Ave., Paco, Manila
designated below.

I understand that there are certain risks of injury inherent in the training, as well
as in travelling and other related activities incidental to my son/daughter’s
participation, and I am willing to assume these risks on behalf of my
son/daughter. I hereby certify that my son/daughter is fully capable of
participating in the PE 3.

In addition to giving my full consent for my son/daughter's participation, I do

hereby waive, its officers, supervisors, and representatives for any injury that may
be suffered by my son/daughter in the normal course of participation in the
designated training and the activities incidental thereto, whether the result of
negligence or any other cause. Name of

Student:_____________________________________________________________________________
CompleteAddress:___________________________________________________________________
Contact No. (Guardian): ____________________________________________________________
Parent/Guardian: ___________________________________________________________________
Signature: __________________________________________________________________________
Date: _______________________________________________________________________________