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Waiver and Release Agreement

I, ________________________, permit the participation of my child _________________________


(Name of Parent) (Name of student)
in the Community Service which will be held during Saturdays of every month from March to May 2022 at
Kalinga State University, Tabuk City, Kalinga under the supervision of the CWTS Coordinator
Adopted School
of the College of Engineering and Information Technology.
(Name of College)
I acknowledge that I fully understand that my child’s participation may involve risk which may result
not only from his/her own actions, inactions or negligence, I understand that if I have any risk concerns, I
should discuss the risks associated with my child’s participation in the community service to the school
authorities involved before I sign this document and before the activity begins.

Knowing and understanding the risks involved with my child’s participation in the community service, I
hereby voluntarily and willingly assume full and complete responsibility for any risks, resulting from my child’s
participation in the activity, including transportation to and from Kalinga State University Bulanao .

I certify that my child is in good health and have no medical condition preventing his/her safe
participation in this community service.

In consideration for Kalinga State University-College of Engineering and Information Technology,


(Name of College)
allowing my child to participate in the community service, I hereby waive all claims or causes of action against
the above-mentioned school arising out of my child’s participation in the activity and hereby release the
instructor involved from all liability in connection therewith.

I have read this waiver and understand the terms used in it and their legal significance. This waiver and
is release freely and voluntarily given with the understanding that right to legal recourse against the school and
their respective instructor is knowingly given up in return for allowing my child’s participation in the
community service. My signature on this document is intended to bind not only myself but also my successors,
heirs, representatives, administrators, and assigns.

Parent: ______________________________________ Date: ________________


(Signature over Printed Name)

Doc. No. 01 s.2019 NSTP- CWTS

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