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Consistent with the University’s advocacy on the environmental sustainability, the University through the NSTP Office has entered into partnership with the Department of Environment and Natural Resources and the Philippine Disaster Relief Foundation in various project intended to promote and protect the environment. This partnership has resulted in the participation of our NSTP students in various tree planting and reforestation initiatives in Antipolo and Tanay, Rizal. It is most likely that your son/daughter may have participated in one of these activities last semester. This coming November, the University will again participate in another environmental project intended to rehabilitate, revived, rejuvenate the Pasig River known as the “11.20.2011: Run for the Pasig River,” sponsored by the ABS-CBN Foundation, Inc. This will be the University’s third year of participation for this worthy effort to rehabilitate the Ilog Pasig. This year’s run for “Ilog Pasig” is intended to directly benefit the communities along the esteros located in the University-belt areas, making our participation even more important. Considering the importance of this initiative, members of the school administration, faculty members and students are expected to join the “Run”. Consistently, the NSTP office has made the “Run” part of the NSTP project. Students enrolled in the NSTP Program, are seriously encourage to join, attend the “11.20.2011: Run for the Pasig River,” and their attendance with will earn them credits. Kindly fill-out the attached “Statement of Parental Consent” and return the same to NSTP Office on or before ________________________ should your son/daughter wish to join or attend the “Run”. Please be informed that the NSTP Facilitators will also be participating in the run. You may call the NSTP Office at 4061611 local 8475 for further inquiries. Sincerely yours, ASST. PROF. JOSE S. CRUZ III NSTP Director
STUDENT UNDERTAKING AND STATEMENT OF PARENTAL CONSENT
This copy to be retained by the faculty (waiver form 2011 series for enjoined activity)
Activity Title : “11.20.2011: A Run for the Pasig River” Where : SM Mall of Asia When : 20 November 2011 (SUNDAY) Nature of the Activity: Advocacy Run (Off-Campus) College / org. (organizer) : ABS-CBN Foundation, Inc. & KBPIP in cooperation with CHED and the University of Santo Tomas Person/Office-In-Charge : _______________________________________ Position: _____________________________ Cell No. : ________________ Tel. No. ____________ E mail :
STUDENT UNDERTAKING, WAIVER AND STATEMENT OF PARENTAL CONSENT
FIRST NAME LAST NAME MIDDLE NAME
ADDRESS MOBILE NO.
Name of person to be contacted in case of emergency: Contact nos.:
I, whose name appears above, hereby express my intention to join the above stated activity, organized by the ABS-CBN Foundation, Inc. & KBPIP in
cooperation with CHED and the University of Santo Tomas to be held on 20 November 2011 (SUNDAY).
deposited to the ABS-CBN Foundation. Office for Student Affairs – for Students 1. Please register early. I take it as my responsibility to take the necessary precaution or care of avoiding or getting involved in any incident that would cause slight. 4.at the 2. upon payment. 2011 for registration. for 6. Registration kiosks are available at: a. Sotto St. from PhP150 to PhP100 only.com/ Thomasian participants (UST Administrators. Assembly area will be at the sites: for 3K = V.20. Facilitators/Representatives and shall be 5. Bayanijuan necklace (souvenir item). registration fees as a group. (downloadable via E-Leap) b. serious or mortal injury upon my person or results in the loss or damage to my property and that of other person. agree to the conditions stated above and consent to the participation of your son/daughter/ward in the said . and for that reason I reiterate that any resulting loss. GUIDELINES ON REGISTRATION AND PAYMENT: PARTICIPATION GUIDELINES FOR THOMASIANS 1.00 for 10K. Check this link: http://www.2011 Run for the Pasig River” organizers. Furthermore.00 for 3K and 5K and PhP450. Computer terminals shall be made completed the run. 7. Students are expected to go directly to the event site at 4:30AM. Present your filled-out Student Undertaking to the NSTP Office. Hospital Personnel. All NSTP Students are expected to come in your NSTP t-shirt and payments shall be received by the NSTP wear footwear appropriate to the event. c. Bring a small bag that will fit your potable water.runforthepasigriver.In connection with the above mentioned activity. I also understand that I am not to engage in any behavior that could or may lead to any incident or could result to loss or damage to property. corner Pedro Gil Puyat The NSTP Office shall deposit the Please look for the UST Yellow Balloon. 4.which includes Office. Attention: For the student. Assigned groupings for the 1st Semester – for Hospital Personnel and shall be retained for the 2nd Semester. 5. 2. I commit to immediately report such condition in writing to the assigned faculty adviser and excuse myself from such an activity. damage. that should I decide not to participate I shall be given another assignment by my NSTP Facilitator to compensate/make up for the activity. Participants must be digitally registered and officially available for on-line registration counted through the “Starting Line” to the “Finish Line” to be considered a ------------------------------------------------------------------------------------------------------------------------. I understand that it is my responsibility to fully ascertain. accounting purposes. 5. Faculty Members. 6. my physical and mental fitness to join this activity. Account. personal medication (if necessary). Office for Public Affairs – for Administrators. I understand that this is a “credited” activity. if necessary with the help of a medical professional. parent or person exercising parental authority over the student concerned. Race Packets (race bib. I am fully convinced that the University and the faculty adviser(s) and organizer(s) of this particular activity have exercised sufficient diligence and care in the preparation and implementation of this activity. 2. Since NSTP students are afforded a discount. and Support Staff. Go to the NSTP Office starting November 8. 7... affixing your signature herein shall mean that you conform. I understand that I must be sufficiently healthy or free from any medical condition that maybe exacerbated or aggravated by my participation in such an activity. I have properly informed my parents or the person(s) exercising parental authority over my person concerning the nature of the activity which I am joining and likewise secured their advice on the measures which I am to undertake for my personal safety and security. Parishioners 3. I have secured their consent for me to join such an activity as evidenced by the signature appearing herein. Register on a per group basis. NSTP & ROTC Offices – for NSTP and ROTC Students 3. injury that may be experienced should be discussed form the vantage of inevitable eventuality. Should I be suffering from any medical condition that maybe aggravated or exacerbated by such an activity. for 5K = along Roxas Blvd. Support Staff. 3. race info. Parishioners and students) will pay a discounted registration fee of only PhP150. injury to myself or other person(s). Faculty Members. Race Bib with RFID chip. A “Finisher Certificate” will be available on-line for those who have 6. No baggage counters will be provided. Water stations will be provided and “portalets” will be made and a souvenir item) shall be distributed available. 8. light snacks. Race Info (routes and guidelines). I hereby warrant and represent that: 1. Pay registration fee at the NSTP be allowed to participate and will be given a race packet --. Only students who have submitted their Student’s Undertaking will 4. extra shirt and towelette. Participants are expected to have read and conformed with the guidelines set by the “11. CCP Complex Inc.
further hold the university free and harmless from any liability arising from the said activity. SIGNATURE OF STUDENT SIGNATURE OF PARENT/GUARDIAN STUDENT’S NAME IN PRINT PARENT/GUARDIAN’S NAME IN PRINT .activity and.
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