DECLARATION FORM & WAIVER

BEO Dated _________________________

List of Equipment & Gadgets, Props & Decors

No. of. Unit/ Equipment/ Gadget/ Props Serial No./ Description Remarks
Piece

I, ______________________, authorized to representative of ____________________________________,

hereby declare that the foregoing equipment/ gadgets/ props/ decors shall be brought inside the premises
of Tagaytay Highlands on ____________________ to be used during the (__________) of
_____________________________________ on even date. Said equipment and gadgets, props and decors
are owned by ____________________________/ __________________________ as contractor of
__________________________.

As authorized representative of _____________________________________________, I hereby voluntarily

and knowingly assume full responsibility for the foregoing equipment/ gadgets/ props/ decors, and forever
hold Tagayaty Highlands, free and harmless from liability and all risks for bodily injury or death, damages,
or claims which ________________________ guests/ employees, consultants, or other personnel may
sustain, directly or indirectly, in connection with the _____________________, and shall forever hold the
Club, its officers, employees, or representatives free and harmless from any and all claims, suits or actions
arising therefrom.

As authorized representative of _____________________________________________, I hereby understand

and agree that this Declaration Form with Waiver may be used to bar or cause the dismissal of any claim,
suit, or action that ________________________________________ guests/ employees, consultants, their
heirs, or assigns may now or in the future be instituted before any court or tribunal in connection with any
matter arising from the _____________.

CONFORME: _______________