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WAIVER

I fully allow my son/daughter ____________________________________to attend and participate in


the 17th NFJPIA National Mid-year Convention on October 25-28, 2014 at DAKAK Beach
Park and Resort in Dapitan City.

I agree to waive release, indemnify and hold harmless the NFJPIA, its officers, advisers,
members, and all the organizers of this event from any all claims of liability arising out of
my child s participation in this activity I also agree to waive that NFJPIA, its officers,
advisers, members and all organizers of this event has responsibility to my child
only within the premises of the venue.

Should my child require medical attention as result of accident or serious illness, I do
hereby grant and bestow upon the organizers of this event permission and authority
for and on my behalf to authorize any licensed medical practitioner to render medical
aid and treatment.

Ailment(s) of your child: ___________________________________
Medication might need: ___________________________________


___________________________________
Name of Guardian

___________________________________
Contact number

Non presentment of this waiver during the registration proper shall be charged P100.00

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