F-SAEP-06

WAIVER FOR OFF CAMPUS STUDENT ACTIVITIES

Date: _____________________

To _________________________,

As parent/guardian of_________________________________________,_______________________________
( Name of Student ) ( Course/Year/Section )
I allow my son/daughter to join and participate in the ______________________________________________________
(Title of Activity)

DETAILS OF THE ACTIVITY

Department
Objectives of the Activity

Date and Place of the Activity

Time and Place of Departure
Time and Place of Arrival
Faculty/Adviser/Staff-in-Charge
Contact Number of Person-in-Charge

I, including my child, know that the University and its officers, faculty and staff have exercised the required
diligence for the safety and well-being of my child for the duration, place, date and time of the activity.

This includes oral/written instructions given before or during the activity which if followed, would ensure the safety
of my child.

If my child fails or willfully disregards to follow the provided instructions or should act on his/her own, we shall
have no claims against the University, its officers, faculty advisers and staff-in-charge should any damage be caused by
or liability incurred to any person or property.

Very truly yours,

Name and Signature of Parent/ Guardian Contact Number

Name and Signature of Student Contact Number

Revision No.: 1 Issue Date: April 3, 2018 Revision Date: March 26, 2018