PARENTAL CONSENT

I, _______________________________, grant permission to my son/daughter,

_____________________________, a student from the
________________________________________________, to participate in the
Palarong Medisina to be held on February 25 and March 04, 2018 at the Adventist
University of the Philippines, Silang Cavite. This activity will take place under the
guidance and direction of the officers of the Association of Philippine Medical Colleges -
Student Network.

I, as a parent and/or legal guardian, remain legally responsible for any personal actions
taken by the above named participant.

I agree on my behalf, my child named herein, or our heirs, successors and assigns, to hold
harmless and defend the Association of Philippine Medical Colleges, Incorporated, its
trustees, officers, staff, employees and agents form any or all actions, claims, demands,
costs, expenses and all consequential damage arising from or in connection with my child
attending the event or in connection with any illness or injury or cost of medical treatment
in connection therewith.

In signing the Parental Consent form, I am not relying on any oral or written representation
or statements made by the university and its trustees, officers, staff, employees, and agents,
to induce me to permit my student to take the trip, other than those set out in this consent
and waiver.

I am 18 years of age or more and have read and understood the terms of this consent and
waiver, and recognize that it is binding upon me, my heirs, executors and administrators.

_______________________________________ ____________________________
Parent/Guardian signature over printed name Date Signed

Home Address:
__________________________________________________________________
Contact No:
____________________________________________________________________
 WAIVER
APMC STUDENT NETWORK ACTIVITY
In consideration of my being permitted/consented by my parents/guardian to participate in
the PALARONG MEDISINA to be held on February 25 and March 04, 2018 at the
Adventist University of the Philippines, Silang Cavite, which my participation in the
activity is voluntary/freely on my part, I, for myself, heirs, parent/ guardian/personal
representatives do hereby release, waive, discharge and covenant not to sue, criminally,
civilly or administratively, and desist from suing the ASSOCIATION OF PHILIPPINE
MEDICAL COLLEGES, INC., its trustees, officers, staff, employees, and agents, from
any and all claims of liability against risks and hazards, including negligence of its trustees,
officers, staff, employees and/or agent, any form of physical injury, accidents, illness, and
property loss or even death arising from or related to my participation in any and/or all of
the above- mentioned activity.

There are requirements for the approval of the APMC-SN activity, and for me joining
voluntarily/freely the activity, I am aware of the requirements and that the APMC-SN
and/or its offices have complied with it.

I have read this waiver of liability and have fully understood its terms. I acknowledge that
I am signing the same freely and voluntarily, and by affixing my signature, it is a complete
and unconditional waiver of all liability to the greatest extent allowed by law.

WITNESS MY HAND this ___ day of ______________, 2018 at

_______________________________________

________________________________________

Signature above printed name of participant

_______________________________

Signature above printed name of parent permitting/consenting participation