Waiver

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University of the Visayas

WAIVER FORM FOR UNDERGRADUATE STUDENT


Date:
To Whom it May Concern:
As the parent/guardian of _____________________________, with ID No:__________,
allow my son/daughter to join and participate in:
Department/ Unit Sponsoring Activity : _______________________________
Nature of Activity : On-the-Job Training 2
Date of Activity : ________________________
Place of Activity : Toledo City
Time of Activity : 0800H-1700H
Faculty/ Adviser/ Staff-In-Charge : 1LT HARVEY A ABELLA, PA (RES)

Together with my child, I know that the University and its officers, Agency, faculty and staff are
expected to exercise the legal diligence required for the safety and well-being of my child for the duration
of the OJT, that if followed, would ensure the safety of my child.
The legal diligence would include oral or written instructions, whether given before or during the
OJT, that if followed, would ensure the safety of my child.
If the child disregards or fails to follow those instructions or should act on his/her own, I ,
together with the child, shall have no claim against the university, its officers, Agency, faculty, adviser,
staff-in-charge should any damage her cause or liability be incurred to property or person. I hereby agree
that if my child is absent for 3 consecutive days, 5 alternate days, or late 5 times and/or any misconduct
during the internship, will be dropped out of the OJT.
Moreover, I hereby give my permission for my child to take part in the OJT as outlined above,
and hereby agree to well and sufficiently indemnify and save harmless the School Board and keep the
School Board indemnified and harmless of any and all demands, actions, proceedings, liability claims,
damages, together with the costs and expenses thereof, that may hereafter at any time be made or brought
by on or behalf of my child for any injury, loss, damage, expense, and costs sustained or alleged to have
been sustained by my child howsoever arising from the aforesaid OJT provided.
Truly Yours’
_____________________________________ ______________________
(Name and Signature of Parents) (Contact Number)

_____________________________________ _______________________
(Name and Signature of Student) (Contact Number)

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