Spring Break from dusk till dawn

RELEASE OF LIABILITY FORM

Location: Nagarao Island, Sibunag, Guimaras
Inclusive dates: February 1-2, 2020

Participation in our event exposes one to many potential hazards. The organizer strives to
manage these risks beyond their control. Some of the inherent dangers and risk that may be
present or occur include, but are not limited to, the following:
 Accidents, illness, or other problems in remote places without cellphones, other means of
communication, or easy access to medical facilities.
 Vehicle accident driven by self or vehicle provided by the organizers
 Forces of nature including lightning, storms, winds rain cold heat weather changes and
changes in water level
 Wounds and injuries to skin, organs, muscles joints and bones
 Injuries inflicted by animals, plants and UV rays.
 Physical exertion that can cause fatigue soreness joint stiffness and blisters.
 Exposure to natural or man-made fire.
 Problems due to defects in manufacturers products or arising from improper use of
products
 Hazards related to water including wading, swimming into water containing cold
temperature, rocks, trees, current, rapids, waterfalls, man-made objects or other obstacle
in water. This can result in hypothermia, injury, entrapment, or drowning.
 Alcohol intoxication
I recognize that each person must be held responsible for his/her own well-being and well-being
of the group. I will share with the other participants of concerns and responsibilities of safety and
to avoid unnecessary hazardous situations, whether those situations have been specified.
I fully understand the dangers of participation in an outdoor activity exposes one to many
potential hazards. I understand that I may be injured as a result of my participation with the
organizers and knowingly assume all risks. In release and forever discharge the travelers of the
Philippines, its organizers, members, agents, and participants of my claims, demands and case of
action arising from my participation in this activity.
I hereby affirm that I have read and fully understand the above and agree to be legally bound by
it. I also affirm that I am over 18 years of age. If under 18 years of age, a letter of a parent/Legal
guardian signature is required.
PLEASE WRITE LEGIBLY AND SIGN ON THE SUCCEEDING PAGE
 Spring Break from dusk till dawn
RELEASE OF LIABILITY FORM
Location: Nagarao Island, Sibunag, Guimaras Inclusive dates: February 1-2, 2020

By signing this form, I have read the liability agreement prepared by the organizers and all
details that I have provided is accurate.

Name Age Date Signature

RAY CARLO ELCHICO
ALLEN JOHN MATTHEW PORRAS
DANIELLE ANGELO YU
GLENDA BAGUIO
GENE LOUISE BAGUIO
MIGUEL PAOLO BAGUIO
MARY JOY HARRIS
ANALINE MAATA
JANEN PALOMO
Dr. ALLAIN BABAO
Dr. KIAN FRANCIS
AJ PARRENO
RACHEL YANUSHEWSKI
Klint Panaguiton
Ivan Paul Hinola
LUCHO LORENZO
JEROME
DOUGLAS BUDOK
Marjorie Ortega
Totchie De la Pena
Cyrel Mariquet
Jazmin Joven
Ronaldo Lamera
JENIE HARVIERE TRISIE
VINSEN
EVELYN BANCAGAY

Spring Break from dusk till dawn

RELEASE OF LIABILITY FORM
Location: Nagarao Island, Sibunag, Guimaras Inclusive dates: February 1-2, 2020
By signing this form, I have read the liability agreement prepared by the organizers and all
details that I have provided is accurate.

Name Age Date Signature

Spring Break from dusk till dawn

RELEASE OF LIABILITY FORM
Location: Nagarao Island, Sibunag, Guimaras Inclusive dates: February 1-2, 2020

By signing this form, I have read the liability agreement prepared by the organizers and all
details that I have provided is accurate.

Name Age Date Signature