Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Scribd Logo
Upload

Welcome to Scribd!

  • 31 views

    Waiver and Quitclaim

    Uploaded by

    mmabejar
    1) The document authorizes dormitory heads/assistants at UPLB to issue permits to allow listed individuals access to the dormitory student upon their child's request for limited purposes such as academic requirements and student activities. 2) The parents assume full responsibility for any incidents involving their child when permits are issued and waive all liability for UPLB and its officers. 3) The authorization is valid for the duration of their child's stay in the dormitory for the current academic terms from the start date to end date listed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Waiver and Quitclaim

    Uploaded by

    mmabejar
    31 views1 page
    1) The document authorizes dormitory heads/assistants at UPLB to issue permits to allow listed individuals access to the dormitory student upon their child's request for limited purposes such as academic requirements and student activities. 2) The parents assume full responsibility for any incidents involving their child when permits are issued and waive all liability for UPLB and its officers. 3) The authorization is valid for the duration of their child's stay in the dormitory for the current academic terms from the start date to end date listed.

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    1) The document authorizes dormitory heads/assistants at UPLB to issue permits to allow listed individuals access to the dormitory student upon their child's request for limited purposes such as academic requirements and student activities. 2) The parents assume full responsibility for any incidents involving their child when permits are issued and waive all liability for UPLB and its officers. 3) The authorization is valid for the duration of their child's stay in the dormitory for the current academic terms from the start date to end date listed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    31 views1 page

    Waiver and Quitclaim

    Uploaded by

    mmabejar
    1) The document authorizes dormitory heads/assistants at UPLB to issue permits to allow listed individuals access to the dormitory student upon their child's request for limited purposes such as academic requirements and student activities. 2) The parents assume full responsibility for any incidents involving their child when permits are issued and waive all liability for UPLB and its officers. 3) The authorization is valid for the duration of their child's stay in the dormitory for the current academic terms from the start date to end date listed.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    AUTHORITY TO UPLB DORMITORY HEADS/ ASSISTANTS

    WAIVER & QUITCLAIM

    We, the undersigned parents hereby authorize the Dormitory Head /Assistant of Residence Hall to issue
    permits and allow those listed below upon request of our child (name) :
    (See note 1 below)

    1) 4)

    2) 5)
    3). 6)

    (See note 2 below)


    for the following limited purposes. (be specific)
    1).
    2).
    3).
    4).
    The validity of this authority, waiver and quitclaim is co-terminus with the period of stay of our child in the Residence
    Hall. Specifically, during:

    First Semester Academic Year from: / / to: / /


    mo. day yr. mo. day yr.
    Second Semester Academic Year from: / / to: / /
    mo. day yr. mo. day yr.
    MidYear Academic Year from: / / to: / /
    mo. day yr. mo. day yr.

    Unless communicated in writing or by email to the Office of Student Housing at osh.uplb@up.edu.ph. We may be contacted
    through the email provided or through our phone: +63 999 221 1483 / (049) 536 2238.

    In case of any untoward incident when our child is permitted by the Dormitory Head/ Assistant as enumerated above, we assume
    full responsibility and accountability and therefore We hereby release and discharge, and by these presents, our heirs,
    successors and assigns, release and forever discharge the UPLB Dormitory Head/ Assistant, the UPLB, its officers, successors
    and assigns, from any and all causes of action, sums of money, accounts, damages, claims and demands of whatever nature,
    whether past, present or contingent against UPLB and its officers, successors and assigns.

    We hereby declare that We have read and understood the content of this document prior to signing thereof and that this
    authority, waiver and quitclaim is made freely and voluntarily and with full knowledge of our rights and responsibilities.

    Mother: Father:
    Printed Name & Signature Printed Name & Signature
    Address: Address:
    Phone No.: Phone No.:
    Email Add.: Email Add.:
    WITNESSES:
    Address: Address:

    I, (student), years old hereby certify under penalty of Sec. 2(a) of the
    Rules and Regulations on Student Conduct and Disciplines 3 that my parents accomplished this document and that I never
    in anyway altered the same after it has been signed.

    Signature
    1 Choose which you allow: Late permit (10PM-12MN), Overnight permit (12MN-6AM), stay with relatives/friends over the week, Early Morning Leave (Leave
    before end of curfew), Late Night Leave (Leave after start of curfew), Waiver for fieldwork, field trips, etc.
    2 Choose which you allow for your child: Academic requirements, student organization activities (for upperclassmen only), other student
    activities (e.g. quiz contest, Feb fair, educational trip/field trips), others: Dinner, Leisure trip, Review/Study outside etc.
    3 Any form of cheating in examinations or any act of dishonesty in relation to his studies – with penalty of suspension for not less than one year, barred from
    graduating with honors notwithstanding weighted average

    You might also like