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Consent Waiver Team Building

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UNIVERSITY OF SAINT ANTHONY

(Dr. Santiago G. Ortega Memorial)


City of Iriga

OFFICE OF THE STUDENT AND ALUMNI AFFAIRS

CONSENT AND WAIVER

OSAA ____________

This is to certify that I am allowing my son/daughter/ward,

_______________________________________________________________________
FIRST NAME MIDDLE INITIAL LAST NAME COURSE/YEAR

to join and participate in the _ TEAM BUILDING____________________


ACTIVITY

_CBE/ STUDENT SOCIETY OF HOSPITALITY MANAGEMENT_


DEPARTMENT/ORGANIZATION

on NOVEMBER 4,2022__ 7:00AM-5:00PM______ __________________


DATE TIME CONTRIBUTION

I fully understand and agree that the University of Saint Anthony (USANT) shall
not be held liable for any untoward incident caused by my son’s/daughter’s/ward’s
negligence and recklessness and/or circumstances beyond the control of USANT.

Done this _______ day of __________, 2022 at _________________________.

________________________________
Parent’s/Guardian’s Signature
Over Printed Name
Contact number/s: _________________

Noted:

______Ms. Lhanie D. Silva_______


Faculty Adviser’s/Dean’s Signature MRS. DAISY S. JUDAVAR
Over Printed Name Dean, Student and Alumni Affairs

USANT-F-OSAA-01 Rev.01 January 03, 2022

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