PLM Waiver

Published on June 2016 | Categories: Documents | Downloads: 131 | Comments: 0 | Views: 573
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Republic of the Philippines
PAMANTASAN NG LUNGSOD NG MAYNILA
(University of the City of Manila)
Intramuros, Manila
Telefax No. 526-68-82
OFFICE OF THE STUDENT DEVELOPMENT AND SERVICES

COLLEGE

:

ACITIVITY

:

DATE

:

TIME

:

VENUE

:

REMARKS

:

______________________________________________________________________________
PARENTAL CONSENT
We allow our son/daughter _______________________________________________________
with Student Number ____________ from (College) _____________________________ _______ taking
up (degree program) _______________________________ join the ___________________________ on
______________________ at _______________________________________.

We voluntarily and knowingly waive all rights of actions against the school, its faculty
member/s. employees. officials, and administrators for any injury or damage, as well as costs,
expenses and liabilities which may incur during or as a result of the event / field trip.
In case of emergency:
Name of contact person
Relationship
Contact Number

:
:
:

________________________________________________
________________________________________________
________________________________________________

We don’t allow our son / daughter ____________________________ to join the
event/fieldtrip.

______________________________________
PARENT’S SIGNATURE OVER PRINTED NAME

____________________________
DATE

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