BATANGAS STATE UNIVERSIRY
College of Engineering, Architecture and Fine Arts
Gov. Pablo Borbon Campus II, Alangilan, Batangas City, Philippines, 4200
www.batstate-u.edu.ph Telefax: (043) 300-4404 locs. 106-118
Philippine Institute of Chemical Engineers- Junior Chapter Batangas
WAIVER
I, , a bonafide Chemical Engineering Student of
Batangas State University with student number do hereby voluntarily join
the PIChE-JCB Team Building Activity on December 20-21, 2014 under the following
terms and conditions:
1. That I shall renounce and waive any claim against the school/establishment for any
injury or accident that I may suffer; and
2. That I shall be answerable for any liabilities for damages of property or injury to
third person/s which may be caused by me intentionally or inadvertently while in
the course of this activity.
Students Signature over Printed Name
Parents/Guardians Signature over
Printed name & Contact No.