WAIVER FORM

Name of Youth Leader

I acknowledge and accept my Son’s/Daughter’s (the youth leader named above)

participation in the upcoming 2nd Singising Summer Youth Camp with the
theme: #Unshakable on May 29-31 at Wallace Air Station, City of San
Fernando, La Union That his/her participation is entirely voluntary and all risk
is voluntary assumed by my Son/Daughter and me.
I understand that the City Government of San Fernando’s rules and
precautionary measures 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 the organizers are
for strict compliance.
In consideration of your agreeing to take my son/daughter on the above
mentioned youth camp, I hereby agree not to hold the City Government of San
Fernando, any employees, facilitators, organizers, City officials, liable for any
loss, personal injury, or accident to my son/daughter which is not the result of
any negligent act or willful default of any of the persons stated above. I will not
bring any suit or assert any claims against the City Government of San
Fernando or the organizers of the youth camp as a result of any action taken.

Signature over Printed Name

Date
NOTE: Please attach a photocopy of Parent’s Valid ID.