8/16/2019 Waiver 2016

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Waiver and Permission Form

This is to certify that I am permitting my

son/daughter,___________________________________to undergo an internship training program

for a total of _______hours starting on _____________ until ,

at__ ____ ____ ____ ____ ____ ____ ____ ____ ____ ____ __ , in partial fulfillment of therequirements for the degree of Bachelor of Science in Computer Science major in

 __________________________.

My son/daughter understands that he/she should strictly oser!e the rules and regulations of 

 ______ "s  (insert name of the institution or company where the internship training is to be conducted)

and #ST, in relation to the said training program and to oser!e all other regulations that may e

implemented y his/her direct super!isor in relation to the same.

I herey agree to $ai!e any responsiility on the part of the %M% College Ceu in

relation to any loss, damage, death, injury or accident that may happen to my son/daughter 

during the said internship training, unless such loss, damage, injury, accident or death resulted

from the fault or gross negligence of %M%.

I also herey agree to hold render %M% free and harmless, including its officers, employees or 

agents, from any liaility, suit or claim filed or made y any party for any injury &including

death' or damage to property that my son/daughter may cause due to his/her $illful acts, fault or 

negligence, $hether or not the same arises from or is related to his/her internship training.

I ha!e li(e$ise read the Internship )ai!er *orm signed y my son/daughter and is fully

agreeale $ith all the things stated thereon.

 _______________________ __________________ ____________ 

 +ame of *ather Signature ate

 _______________________ __________________ ____________ 

 +ame of Mother Signature ate

 _______________________ __________________ ____________  +ame of -uardian Signature ate

 +ame of Student  ___________________________________ 

ome %ddress  ___________________________________ 

Telephone +o.  ___________________________________ 

Moile +o.  ___________________________________