Office

of Student Affairs and Services

Student Organizations and Activities Unit

WAIVER

I am allowing my son/ daughter ________________________ to participate in

the Tree Planting Activity for 4th Year/Graduating Students to be held on April 17,
2024 at Mt. Banahaw De Lucban.

I acknowledge that the event coordinators and the Office of Student Affairs and
Services at the Southern Luzon State University will implement appropriate safety
measures for this activity.

Recognizing the educational and personal development opportunities afforded by

this participation, I voluntarily waive any claims against the university administration, or
any personnel involved in the organization of this activity, due to any unexpected
incident or injury that may occur while my son/daughter is engaged in the event.

______________________________ __________________
Signature over printed name of Parents/Guardian Date

______________________________ __________________
Signature over printed name of Student Date

AA-OSAS-1.01F3, Rev.2