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UNIVERSITY OF ANTIQUE
Mayor Santiago A. Lotilla St., Sibalom, Antique www.antiquespride.edu.ph
036-543-8161 ua@antiquespride.edu.ph ISO 9001:2015 Certified

UNIVERSITY OF ANTIQUE
College of Business and Accountancy
Sibalom, Antique

JOINT AFFIDAVIT OF WAIVER OF LIABILITY

I, Filipino Citizen, of legal age and resident

of after having been duly sworn in
accordance with law hereby depose and say;

That I am a legitimate parent/guardian of ,

a third year student for the course BACHELOR OF SCIENCE IN OFFICE ADMINISTRATION
at the University of Antique with the business address at Sibalom, Antique;

That my son/daughter is desirous to take

his/her practicum training in University of Antique – Main Campus.

That I, being a parent/guardian of

, do hereby grants him full parental consent and
allows his/her to have practicum as one of the requirements in the course for his/her to be able to
graduate;

That I, as parent/guardian fully understands that the University of Antique requires its
students to have practicum only locally and within the island of Panay so as to facilitate easy
monitoring but because of personal convenience I petitioned the school authorities to allow my
son/daughter to have his/her practicum in a company of our voluntary choice;

That I, , a student of the University of

Antique, enrolled in the course Bachelor of Science in Office Administration is desirous to take
my practicum at University of Antique – Main Campus with business address at Sibalom,
Antique.

That this waiver of liability is purely on accommodation of the PARTNER

INSTITUTION upon the request of the UNIVERSITY and as such, the partner institution shall
not be liable for any kind of injury, death and/or damage to property caused by accident or force
majeure during the training and/or any act or situation arising from negligence of the student-
trainee in the performance of his function while under training, provided said partner institution
has exercised good parental authority over the trainees;

That because we voluntarily and personally choose the practicum venue of our children
outside that of which is prescribed by the University, we hereby acknowledge joint responsibility
in the monitoring and protection of our children with the University during the period of the
practicum: and

Further that, there is no employee-employer relationship between the PARTNER

INSTITUTION and the trainee;

By the virtue of this sworn statement, I would like to inform the authorities concerned
about the facts herein stated and to request that the same joint affidavit be considered and/or
granted.

PO-FM-008 Transforming Lives, Building Communities. REV.2/08-11-20