Updated Waiver For Make Up Classes

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Republic of the Philippines

UNIVERSITY OF NORTHERN PHILIPPINES


Tamag, Vigan City
2700 Ilocos Sur

PARENTS’ CONSENT AND WAIVER

I AM PERMITTING ______________________________________________________, who is my


(Name of Student: Family Name, Given Name, and Middle Name)
_____________________________, enrolled in the University of Northern Philippines, Vigan City in the
(Relationship to the Student)
__________________________to attend ______________make-up classes_______________________.
(Title of Activity)

With the following details:


• Place/Venue of Activity : University of Northern Philippines
• Date and Time of the Activity : October 26 and November 9, 2024, 8:00 AM – 5:00 PM
• Name of Supervising Faculty Member : Sheila L. De Vera / Kristalyn A. Garcia
•Contact Number of the Supervising Faculty Member: 09989516404 / 09058440206
• Amount of Contributions/ Payments (if any) :___none___________________
• Diet Restrictions (if any):______________________, present/Existing Ailment (if any):_____________
• Objectives of the Activity:
To assist the students in catching up with the course material, which were missed during the
series of class suspensions due to typhoons and other academic and extra-curricular activities of the
students especially during the intramurals.

IN THE EVENT THAT __________________________________sustains damages by reason of


injuries or untoward events inflicted by an act of omission of himself/herself or by a fellow student or a
third party during the activity or while supervision or control is still present, I hold the supervising faculty
FREE from liability only when it is proven that he/she exercised or observed all the diligence of a good
father of the family to prevent the damage.
LASTLY, I hold the University or any officials free from any liability should it be proven that they
exercised the diligence of a good father of the family in the selection and supervision of its employees.
That I am of legal age and have read and understand the provisions of this consent and waiver that it is
binding upon me and the university.

_______________________________________ ID Issued:_____________________________
(Signature Over Printed Name of Parent/Guardian) ID Number:____________________________
(Date Signed)______________________

REPUBLIC OF THE PHILIPPINES


CITY OF VIGAN…………………….) S.S.

SUBSCRIBED AND SWORN to before me this _____ day of _______________________ (Month & Year) at
Vigan City, Ilocos Sur exhibiting his/her identification indicated above his/her respective name and
signature.
Doc. No.
Page No.
Book No.
Series of 2024

Quirino Blvd., Brgy. Tamag, Vigan City, 2700 Ilocos Sur ISO 9001:2015
Website: www.unp.edu.ph
REGISTERED
Email: [email protected] Telephone # 09173171968
Certificate. No.

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