COLEGIO DE NAIC

Governor’s Drive Ibayo Silangan, Naic, Cavite

Email add.: colegio_de_naic@yahoo.com
SY. 2020-2021

PARENTAL CONSENT AND WAVER FORM

I, __________________________, grant permission for my son/daughter,
______________________, to participate/ partake/ engage in the Work Immersion Program. This
activity will take place under the guidance and direction of the Immersion teacher and

Location of the Company: ____________________________

Duration: _______________________________

Mode of Transportation: _________________________

I, as a parent, and/ or legal guardian, remain legally responsible for any personal actions taken
by the above named participant.

I agree on behalf of myself, m y child named herein, to hold harmless and defend Colegio de
Naic, its officers, employees, faculty, or representatives associated with the event6, from any and all
actions, claims, demands, damages, costs, expenses and all consequential damage arising from or in
connection with any illness or injury or cost of medical treatment in connection therewith.

In signing the Parental Consent Waiver, I am not relying on any oral or written representation or
statements made by the school and, its officers, employees, faculty, or representatives associated with
the event, to induce me to permit my student to take the Work Immersion, other than those set out in
this Consent and Waiver.

I have read and understood the terms of the consent and waiver, and recognized that it is
binding upon me, my heirs, executors and administrators.

SIGNED IN THE PRESENCE OF:

__________________________ __________________________
Parent/ Guardian over Printed Name Date Signed