Republic of the Philippines

Department of Education
Region V - Bicol
SCHOOLS DIVISION OFFICE OF ALBAY
PIO DURAN TEACHER’S ORGANIZATION
Pio Duran, Albay

WAIVER
CERTIFICATION OF EMPLOYEE’S CONSENT AND LIABILITIES
Name(___________________________________)
Position Title:_____________________ District:__________________________
Inclusive Dates:____________________
ITINERARY-ILOCOS PROVINCES and BAGUIO CITY
Transportation: Arandia Lines/
I____________________________of(Address)_______________________________Regular
Permanent at (School) _______________________________having been accepted to join the
tour Educators Tour of Pio Duran Teachers to be scheduled on June 2-7,2024 in Ilocos
Provinces and Baguio City.
After giving my full consent/ permission to join the activity mentioned above, I do hereby
resolve and free Pio Duran Teachers Organization for whatever liability, damaged or claim of
whatever nature and kind may arise by reason of the said activity. Medical, accidental or
otherwise by reason of unforeseen circumstances of through force majeure, and not the result
of negligence, omission or commission by any faculty member, personnel, employee of officer of
the organization.
Done this _____________ day of June,2024 at Pio Duran Albay.

Conformed:
______________________________
Signature over printed name