CONSENT AND WAIVER

OSAA ____________

This is to certify that I am allowing my son/daughter/ward,

______________________________________________________________________________
FIRST NAME MIDDLE INITIAL LAST NAME COURSE/YEAR

to join and participate in the WATER SEARCH AND RESCUE TRAINING

ACTIVITY

COLLEGE OF HEALTH CARE EDUCATION

DEPARTMENT/ORGANIZATION

on MARCH 4-5, 2024 7:00 AM to 5:00 PM P193.00

DATE TIME CONTRIBUTION

I fully understand and agree that the University of Saint Anthony (USANT) shall not be
held liable for any untoward incident caused by my son’s/daughter’s/ward’s negligence and
recklessness and/or circumstances beyond the control of USANT.

Done this _______ day of __________, 2024 at _________________________.

____________________________________
Parent’s/Guardian’s Signature
Over Printed Name
Contact number/s: _________________
Noted:

MR. RONALD C. ABAÑO, RN, MAN, PhD(c)

Dean, College of Health Care Education
Faculty Adviser’s/Dean’s Signature MRS. DAISY S. JUDAVAR
Over Printed Name Dean, Student and Alumni Affairs

USANT-F-OSAA-01 Rev.01 January 03, 2022