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Affidavit of Consent and Waiver Form

The document is an affidavit of consent and waiver for a student to participate in an activity. It grants permission for the student to participate and waives liability of the university for any accidents. The document also includes an acknowledgement section to be signed by the student and parent/guardian before a notary public.

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604 views2 pages

Affidavit of Consent and Waiver Form

The document is an affidavit of consent and waiver for a student to participate in an activity. It grants permission for the student to participate and waives liability of the university for any accidents. The document also includes an acknowledgement section to be signed by the student and parent/guardian before a notary public.

Uploaded by

gtxcwshgw4
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

Republic of the Philippines

College of Public Administration and Governance


Tarlac State University
Tarlac City, Tarlac

AFFIDAVIT OF CONSENT AND WAIVER

I, Parents/Guardian Name, of legal age, Filipino, residents of Address under oath declares
that:

1. Student Name, whose signature appears below, is our son/daughter who is currently
enrolled at Tarlac State University, College of Public Administration and Governance.
2. I grant permission for him/her to participate in the Title of Activity, Address/Venue, on
date of event.
3. I fully understand that TSU shall not be liable in whatever form or manner of loss of life
or limb of the student in the duration of the said activity, or shall any of the TSU
authorities be held responsible for any accident which may be met by him/her during the
event through his/her own fault or his own making.

____________________________ ___________________________
Student Parent/Guardian
(Signature over Printed Name) (Signature over Printed Name)

ACKNOWLEDGEMENT

REPUBLIC OF THE PHILIPPINES


CITY OF TARLAC
PROVINCE OF TARLAC
BEFORE ME, Notary Public and with the City of Tarlac on this ______ day of _______ 2023 at
___________________, personally appeared:

Name I.D. No. Date/Place of Issue


________________________ __________________________ __________________
________________________ __________________________ __________________

Known to me to be same person who executed the foregoing instrument and they acknowledged to me the same as
their free voluntary deed.

IN WITNESS HEREOF, I have here unto set my/our hand and seal on the date and place above written.

Doc. No. _______


Page No. _______
Book No. _______
Series of 20 _____

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