Download as docx, pdf, or txt
Download as docx, pdf, or txt
You are on page 1of 2

REPUBLIC OF THE PHILIPPINES}

________________________________ } S.S.

ASSUMPTION OF RISK, WAIVER, AND RELEASE FROM LIABILITY

KNOW ALL MEN BY THESE PRESENTS:

            That I, _______________________________________, Filipino citizen, of legal


age, ________, a resident of _________________________________________________
and presently employed with ASIAN TECHNOLOGY SERVICES, INC. (the
“Company”), do by these presents understand and acknowledge that I volunteered
and requested the Company to allow me to work with twelve (12)-hour work shifts
in the Company’s office premises despite the on-going Covid-19 pandemic outbreak
and the previous medical treatments that I have undergone for leukemia, other
hematologic conditions, and cardio-related diseases during the period of
________________ to _______________. At present, I am no longer required to take
any form of medications and I am likewise declared free from any medical or health
conditions as evidenced by the attached Medical Certificates issued by
___________________ and __________________ dated ________________ and
________________ respectively.

I fully understand and acknowledge that my continued rendering of work


with twelve (12)-hour work shifts at the office premises of the Company, including
my travel to and from the office premises, may expose me to risks such as Covid-19
infection which may result to illness or death. I recognize that the nature of my work
does not allow me to render my tasks, duties and assignments from home and that
instead of being placed under a “no-work-no-pay” scheme, I have requested the
Company to allow me to work at the office despite my knowledge of all the risks
involved. In view thereof, I voluntarily assume all the risks that may arise out of or
result from working at the office premises, including those risks as described above.

            In consideration of my willingness to accept and assume the risks involved in


continuing to render work at the office premises of the Company, I do hereby
unconditionally release the Company, its directors, officers, employees, agents and
clients from all liability relating to my continued working at the office premises of
the Company during the Covid-19 pandemic outbreak.

Further, I do hereby release, waiver, discharge, and covenant that I will not
file any actions, claims, disputes, grievances or complaints of whatever nature,
expected, real or apparent, which I may have against the Company, its directors,
officers, employees, agents and clients by reason of or arising from my continued
rendering of work at the office premises of the Company. I will institute no action,
whether civil, criminal, labor or administrative against the Company, its directors,
officers, employees, agents and clients. 

            I declare that I have read this document and have fully understood its
contents.  I further declare that I voluntarily and willingly executed this Assumption
of Risk, Waiver and Release from Liability with full knowledge of my rights under the
law.

           

1
IN WITNESS WHEREOF, I have hereunto set my hand at _______________,
this _______________ 2021.
____________________________
Signature Over Printed Name

SUBSCRIBED AND SWORN to before me this _______________ 2021 in


_____________ City, affiant exhibiting to me his identification card, as follows:

Identification Card No. Issued at Expiring on

Doc. No. _____;


Page No. _____;
Book No. _____;
Series of 2021.

You might also like