AMA Computer College-Caloocan Campus
263 UE Tech Road, Samson Road Caloocan City
363-8551 • 367-7227
WAIVER
December 4, 2018
This is to certify that I am waiving any claims against AMA COMPUTER COLLEGE –
CALOOCAN CAMPUS, from any liabilities arising from any injury that may be sustained
during the WORK IMMERSION of my daughter/son,Amaro,Blesziel residing at 123 B.
Santos St. Isla San Juan Maypajo Caloocan City from Dec.4,2018 to January,16
2019
WITH OUR CONSENT/APPROVAL:
_______________________________
Name of Parent/Guardian
Signature over Printed Name
AMA Computer College-Caloocan Campus
263 UE Tech Road, Samson Road Caloocan City
363-8551 • 367-7227
Ms. Jamie Earl A. Zablan Ms. Kimberly O. Chua
SHS Work Immersion Head SHS Coordinator
Signature over Printed Name Signature over Printed Name
Mrs. Ma. Carla A. Ramos
School Directress
Signature over Printed Name