Polytechnic University of The Philippines: Plant Tour Waiver of Liabilities

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POLYTECHNIC UNIVERSITY OF THE PHILIPPINES

Taguig Campus
General Santos Avenue, Lower Bicutan, Taguig City
Tel Nos:, (02) 8375858-59

PLANT TOUR WAIVER OF LIABILITIES


The Polytechnic University of the Philippines - Taguig Campus with postal address at
General Santos Avenue, Lower Bicutan, Taguig City, hereby agrees to endorse
__________________________________
to
undergo
his/her
plant
tour
in
________________________________________________
for
his/her
subject/s
___________________________________________ which is an academic requirement on
(Subject Code /Description)

his/her degree, under the following terms and conditions:


1. That he/she shall abide the school's rule and requisition and shall comply with those
imposed for the programs; otherwise he/she shall be excluded from further participation.
2. That PUP Taguig Campus and the school where he/she will be placed shall not in any way be
held liable for any accident or injury that he/she may suffer in the course of his plant tour.
3. That he/she should be made answerable in any and all liabilities for damage to property or
injury to third persons, which may be occasioned by his/her intentional or negligent acts as while in the
course of his/her plant tour.

Signed this ___ day of __________, 2015 at Polytechnic University of the Philippines,
Taguig Campus. I hereby waive/renounce the right to any claim for compensation or course
of action against PUP Taguig in any case of accident/injury during the duration of the plant
tour.
__________________________________
Name of Student
Witness:
__________________________________
Plant Tour Coordinator

PARENTAL CONSENT FORM


I,
__________________________________,
of
legal
age
and
a
resident
of
___________________________________________________, hereby authorize the Polytechnic University of the
Philippines- Taguig Campus, to send _______________________________________ for the Plant Tour.
I hereby waive/renounce the right to any complaint for compensation or course of action
against PUP Taguig and _______________________ in any case of any accident/injury in the course of the
Plant Tour.
In view of the foregoing, I hereby affixed my signature below this ___ day of January 2015 at
Taguig City.

________________________________
Affiant
JURAT
SUBCRIBED AND SWORN to before me this ___ day of February 2014, affiant exhibiting to me
his/her
government
issued
Identification
Card
No.
_____________________
issued
by________________________
with
expiry
date
on
_________________.
(Name of Government Agency)
WITNESS MY HAND AND SEAL on the day first above written.

NOTARY PUBLIC
Doc No.______;
Page No._____;
Book No._____;
Series of 2014

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