BATAAN PENINSULA STATE UNIVERSITY

BS IN MECHANICAL ENGINEERING

WAIVER FORM
___________________________________________

NAME OF STUDENT

I acknowledge and accept that my son’s/daughter’s (the student named

above) participation in the Mechanical Engineering Educational Plant Tour is entirely
voluntarily and all risk is voluntarily assumed by my son/daughter and me.

I also acknowledge paying Tour Fee of P 6,150.00 for three (3) days and two (2)
nights until November 16, 2018 which was already discussed during Orientation Seminar
of Parents of Fifth year Mechanical Engineering Students last October 16,2018.

I understand that school rules and regulations will be in effect. I have also ensured
that my son/daughter understands that it is important for his/her safety, and for the
safety of the group, that all rules and instructions given by Plant Tour Supervisor are
obeyed.

In consideration of your agreeing to take my son/daughter on the above trip, I

hereby agree not to hold the school, any individual employed by the school liable for
any expense, loss, personal injury, or accident to my son/daughter which is not the result
of any negligent act or willful default of any employee or instructor of the school. I will
not bring any suit or assert any claim against BPSU or the Field trip supervisors as a result
of any action taken.

Parent’s Name

Parent’s Signature

Date