Republic of the Philippines

NAVAL STATE UNIVERSITY

Naval, Biliran
Telefax: (053) 500-9045

College of Maritime Education

PARENT/GUARDIAN CONSENT

________________

Date

TO WHOM IT MAY CONCERN:

This is allowed my son/daughter _______________________________, BS______________

student to participate in the Basic Training, Engineering/ Navigational Watch keeping,
Crowd and Crisis Management (CCM) and Seafarers with Designated Security Duties
(SDSD) on April 14 May 6, 2016 in Cebu City.

Yours truly, APPROVED:

_______________________ _____________________________
Name of Student Name of Parent/ Guardian
(Signature- Over- Printed Name) (Signature- Over- Printed Name)

___________________________________________________________________________

STUDENT WAIVER

I,___________________________ (name) presently enrolled in _______________________

______________ (course/ year & section) present me to join the ______________ as part of our
school activity and do hereby ledge that:

1. I will obey and abide the rules and regulations promulgated, enforced by the officials of the
University for the protection and safety of all;

2. That I hereby waived and renounce my rights to all damages, hospitalization, and the like and
I will not hold the employees or stuff of MUST responsible for any misfortune, injury, or
accident be slight or serious, that may happen in connection with the activities or
requirements.

That the content of this waiver was read and explained to me before I affix my name and signature
this ________ day of _____________ freely and voluntarily.

Thank you very much!

Yours truly, APPROVED:

__________________________ ___________________________
Name of Student Name of Parent/ Guardian
(Signature-Over- Printed Name) (Signature-Over- Printed Name)