Bulacan State University

College of Criminal Justice Education

City of Malolos, Bulacan

WAIVER

I, Joana Heidi P. Pagdanganan, of legal age, Filipino, single and

with residence and postal address at #539 Pungo, Calumpit, Bulacan,
through the request of the Bulacan State University and Office of the City
Assessor of Malolos in consideration thereof, hereby freely and voluntarily
assume and impose upon myself the following duties:

That I recognize the authority of the Office of the City Assessor of

Malolos under whom I am placed and submit myself to rules and regulations
that maybe imposed in connection with my training;

That I assume full responsibility to all damages incurred by me arising

out of and in course of my training during hours;

Furthermore, I renounce and waive all claims against Bulacan State

University and Office of the City Assessor of Malolos for any injury that
may sustain or any loss that I suff er, personal or pecuniary, in
the performance of my duties or functions.

Signed at Malolos, Bulacan this 26th of October, 2015

__Joana Heidi P. Pagdanganan__

Affiant
WITNESSETH:

__ Beatrix V. Pagdanganan__
__Jannah L. Mungcal__

CONFIRMATION
That we , Virgilio D. Pagdanganan and Jean P. Pagdanganan, of
legal ages,
Filipino and a resident of #539 Pungo, Calumpit, Bulacan , after being duly
sworn in
accordance with law hereby agree and state :
That we hereby confirm the above waiver appearing in this instrument.

___________________________________
Signature of Parents/Guardian.

_______________________________________
Signature of
Parents/Guardian

SUBSCRIBED AND SWORN to before me in the City of Malolos, Province

of Bulacan,this _______th day of _________________ 2015 , affiant exhibiting
his/her _________________________________________________________issued at
_____________________________ on ____________________________________________
.
_____________________________________
Administering Officer

Doc. No. _______________

Page No. _______________
Book No. ______________
Series of 2015