BESTLINK COLLEGE OF THE PHILIPPINES - BULACAN INC.

Lot 1 Ipo Road, Brgy. Minuyan Proper Area-A, City of San Jose Del Monte, Bulacan
Tel No. (044) 797-2949

CONSENT, WAIVER AND RELEASE

KNOW ALL MEN BY THESE PRESENTS:

That I, Georgie A. Cayabyab, a Filipino, 27 years of age,

resident and post office address at Blk UC 3 Area G Brgy Citrus City of San Jose Del Monte Bulacan,

Philippines, and a student of Bestlink College of the Philippines – Bulacan Inc., being a fourth year
student under the program of Bachelor of Technical – Vocational Teacher Education in Food Service
Management and in connection with internship in Sapang Palay National Highschool.

___________________, hereby manifest my consent to being such a participant, and by these presents
hereby waive, discharge and release the ___________________________________ its officers,
members and employees from any and all liabilities, cause or causes of action, sum or sums of money
and damages for any accident that may befall me during the entire period of immersion and that I sign
this CONSENT, WAIVER and RELEASE freely and voluntarily and consciously with full knowledge of my
rights under the law.

IN WITNESS WHEREOF, I have hereunto affixed my signature this ____ day of ____ at Bestlink
College of the Philippines – Bulacan Inc.

GEORGIE A. CAYABYAB MA.GERLIE A. CAYABYAB

SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME
Student Parent/Guardian

Signed in the Presence of:

LEILANI I. CUSACK, Ph. D. Ms. Mikee T. Mallo

School Directress SHS Coordinator