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National Federation of Junior Philippine Institute of Accountants National Capital Region Council Philippine School of Business Administration-QC Junior

Philippine Institute of Accountants


GAME OF THE GIANTS AN UPSIZED GAME EXPERIENCE November 13 & 20, 2011 Philippine School of Business Administration-QC
In cooperation with

9th NCR JPIALYMPICS

WAIVER
NAME: ________________________________________ LOCAL CHAPTER: ______________________________ List all the ailments you suffer from: _______________________________________________________________________________________________ EMERGENCY INFORMATION: CONTACT PERSON 1: _____________ PHONE: ______________ CELLPHONE NUMBER: _________________ CONTACT PERSON 2: _____________ PHONE: ______________ CELLPHONE NUMBER: _________________ Should I require medical attention as result of accident or serious illness, I do hereby grant and bestow upon the organizers of this event permission to authorize any licensed medical practitioner to render medical aid and treatment. I also agree to the following: In the case of minor injuries, treatment will be given at the first aid station within the venue. In the case of major injuries requiring treatment outside the venue, the NFJPIA NCR Council will shoulder 50% of the total amount charged or Php10,000, whichever is lower. I agree to waive release, indemnify and hold harmless the NFJPIA NCRC, its officers, advisers, members, and all the organizers of this event from any all claims of liability arising out of my participation in this activity. I also agree to waive that NFJPIA NCRC, its officers, advisers, members and all organizers of this event has responsibility only within the premises of the venue.

CONFORME:

_______________________________________ SIGNATURE OVER NAME

_____________________ DATE

National Federation of Junior Philippine Institute of Accountants National Capital Region Council Philippine School of Business Administration-QC Junior Philippine Institute of Accountants
GAME OF THE GIANTS AN UPSIZED GAME EXPERIENCE November 13 & 20, 2011 Philippine School of Business Administration-QC
In cooperation with

9th NCR JPIALYMPICS

WAIVER
NAME: ________________________________________ LOCAL CHAPTER: ______________________________ List all the ailments you suffer from: _______________________________________________________________________________________________ EMERGENCY INFORMATION: CONTACT PERSON 1: _____________ PHONE: ______________ CELLPHONE NUMBER: _________________ CONTACT PERSON 2: _____________ PHONE: ______________ CELLPHONE NUMBER: _________________ Should I require medical attention as result of accident or serious illness, I do hereby grant and bestow upon the organizers of this event permission to authorize any licensed medical practitioner to render medical aid and treatment. I also agree to the following: In the case of minor injuries, treatment will be given at the first aid station within the venue. In the case of major injuries requiring treatment outside the venue, the NFJPIA NCR Council will shoulder 50% of the total amount charged or Php10,000, whichever is lower. I agree to waive release, indemnify and hold harmless the NFJPIA NCRC, its officers, advisers, members, and all the organizers of this event from any all claims of liability arising out of my participation in this activity. I also agree to waive that NFJPIA NCRC, its officers, advisers, members and all organizers of this event has responsibility only within the premises of the venue.

CONFORME:

_______________________________________ SIGNATURE OVER NAME

_____________________ DATE

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