Permission to Join the Coastal Clean-up and Waiver Form

Permission to Join the Coastal Clean-up and Waiver Form

This activity is an avenue for the students to really take part of their social responsibility and put into practice the things that they have learned in the classroom. However, Iligan City National High School (ICNHS) cannot assume responsibility for the safety and welfare of students while engaged in a Coastal Clean-up at Sampayan beach of Barangay Tomas Cabili, Iligan City on April 20, 2010 from 8:00 AM – 12: 00 NN beyond making reasonable provision for activity chaperone.

        I understand that the science teacher Mrs. Annallee Q. Aron (chaperone/ science teacher) cannot prevent injuries because she cannot always control the conditions present or be present at all times.
        I, the undersigned, clearly agreed on the following to (1) accept general liability for the participation of my child in the said activity  (2) indemnify and hold harmless ICNHS, its Department of Education, its employees and agents, either jointly or severally, from and against any and all claims, damages, causes of action or injuries, including reasonable attorneys’ fees and costs expended in defense thereof, incurred or resulting from my child’s participation in this activity including transportation.

Phone (residence): ____________Parent’s cell no.: ____________
Phone (work) ______

Student’s Signature:  

  Signature over printed name     

Parent's/Guardian's Signature: 

Signature over printed name  

Printable copy:


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