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Waiver of Liability for Student Internship

1) Maria Lourdes C. Fernandez is waiving all rights against San Pedro College and Focus, Inc. for any accidents or emergencies that may occur to her daughter Camille C. Fernandez during her work experience placement from June 8, 2015 to October 15, 2015 as part of Camille's Bachelor of Science in Psychology program. 2) Camille C. Fernandez and Maria Lourdes C. Fernandez signed the waiver in Davao City, Philippines on August 16, 2015 in the presence of two witnesses. 3) A notary public in Davao City witnessed Maria Lourdes C. Fernandez and Camille C. Fernandez sign the waiver and acknowledged their signatures.

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2 views2 pages

Waiver of Liability for Student Internship

1) Maria Lourdes C. Fernandez is waiving all rights against San Pedro College and Focus, Inc. for any accidents or emergencies that may occur to her daughter Camille C. Fernandez during her work experience placement from June 8, 2015 to October 15, 2015 as part of Camille's Bachelor of Science in Psychology program. 2) Camille C. Fernandez and Maria Lourdes C. Fernandez signed the waiver in Davao City, Philippines on August 16, 2015 in the presence of two witnesses. 3) A notary public in Davao City witnessed Maria Lourdes C. Fernandez and Camille C. Fernandez sign the waiver and acknowledged their signatures.

Uploaded by

Mitch Sabio
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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WAIVER OF CLAIM

KNOW ALL MEN BY THESE PRESENTS:


I, MARIA LOURDES C. FERNANDEZ, parent/guardian of CAMILLE C.
FERNANDEZ a student of San Pedro College, am aware that he/she will be exposed
to various management, analytical or technical activities under the Bachelor of
Science in Psychology Program, so that knowledge, interest and enthusiasm on
various management field will be harnessed.
As such I will waive all my rights against the
BACHELOR OF SCIENCE IN PSYCHOLOGY PROGRAM
Under the
ARTS AND SCIENCES DEPARTMENT
Of
SAN PEDRO COLLEGE, INC.
The school where my son/daughter is presently studying and or the agency
represented by:
FOCUS, INC.
The establishment where he/she is presently assigned for work experience on
whatever accidents or emergencies is forever discharge and release from any
liability that may arises as a result of or during the conduct of this program for the
period covered:
JUNE 8, 2015 OCTOBER 15, 2015
That this Waiver maybe pleaded as a bar to any suit or proceedings arising from my
On the Job Training.
IN WITNESS WHEREOF, we have hereunto set our hands this 16th day of August 2015
in the City of Davao, Philippines.
__CAMILLE C. FERNANDEZ__
MARIA LOURDES C. FERNANDEZ
(Signature over printed name)
printed name)
Student
Parent/Guardian

(Signature over

SIGNED IN THE PRESENCE OF:


1. ______________________
(Signature over printed name)
printed name)

2. ______________________
(Signature over

ACKNOWLEDGEMENT
REPUBLIC OF THE PHILIPPINES)
CITY OF DAVAO..........................) S. c.
BEFORE ME, Notary Public of Davao City, Philippines, this __________________,
personally appeared _________________ (Parent/Guardian) exhibited her/his
Competent
Evidence
of
Identity
to
wit:
________________________
and
____________________ (student) with her/his Competent Evidence of Identity to wit:
________________________ and to me known to be the same persons who executed the
foregoing instrument which consists of only one (1) page on which the
acknowledgment is written and signed by the parties executing this instrument and
their witnesses and sealed with my notarial seal and they acknowledged to me that
their signature on the instrument was freely and voluntarily affixed by them for
purposes stated therein.

IN WITNESS WHEREOF, We have hereunto set our hands at the place and
dated above-mentioned.
Doc No. ____;
Page No. ___;
Book No. ___;
Series of 2015

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