WAIVER OF LIABILITY

I __________________________________, of legal age, _________________ and residing at

(Name)
(Civil Status)
_____________________________, do hereby state that:
(Place of Residence)
1. I am an employee of the Provincial
_______________________________.
(Office/Department)

Government

of

Batangas

under

the

2. I am voluntarily joining the activities of the Provincial Government of Batangas Mini-Olympics

2016.
3. (i) I am in good health and in proper physical condition to participate in the Activities; and (ii) I
am not under the influence of alcohol or any illicit or prescription drugs which would in any way
impair my ability to safely participate in the Activities. I agree that it is my sole responsibility to
determine whether I am sufficiently fit and healthy enough to participate in the Activities.
4. I agree to be familiar with and to abide by all rules and regulations established for the Activities
in which I participate. I also accept sole responsibility for my own conduct and actions while
participating in these Activities and the condition and adequacy of any equipment that I might
own and supply in conjunction with those Activities.
5. I am releasing the Provincial Government of Batangas, any of its officials, or any of the
organizers of the Provincial Government of Batangas Mini-Olympics 2016 from any liability
whatsoever, monetary or otherwise, or from any liability, civil, criminal or administrative in
nature for any personal injury or damage that I may suffer due to my own fault or negligence or
cased by any third party.
6. I hereby warrant that I have read this document carefully, understand its terms and conditions,
acknowledge that I have signed this Agreement freely and voluntarily, without any inducement,
assurance or guarantee, and intend for my signature to serve as confirmation of my complete and
unconditional acceptance of the terms, conditions and provisions thereto.
Date: __________________

_______________________________________________
(Signature of Participant)