8/16/2019 Waiver 2015

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Internship Waiver Form

I am , yrs. old and a______ year studentof the AMA College Cebu.

In partia l fulfillment of the requirements for my degree of Bachelor of Science in Computer Science,

major in _______________________, I shall be undergoing an internship training for a total of 

 ______________ hours st ar ting on _______________until ______________________, at

In relation to the said internship training

a! I ta"e it as my responsibility to ta"e the necessary precautions to a#oid or get in#ol#ed in

any incident that could cause loss, damage or injury to my o$n person or that of 

another%

 b! I understand that it is my responsibility to fully ascertain, if necessary $ith the help of a

medical professional, my physical and mental fitness to join such acti#ity%

c! I understand that I must be sufficiently healthy or free from any medical condition that may

 be e&acerbated or aggra#ated by my participation in such an acti#it y. Should I be

suffering from any medical condition that may be e&acerbated or aggra#ated by

 participating in such acti#ity, I commit to immediately report the same in $riting to the

assigned faculty coordinator and to e&cuse myself from the said acti#ity.

d! I hereby declare tha t I understand t ha t I should strictly obser#e_________________________ 

 _____________________________________ 's (insert name of institution or company where

the internship training is to be conducted) rules on security and confidentiality of businessinformation and other regulations that may be implemented by my direct super#isor and our 

faculty coordinator in relation to my training%

e! I ha#e properly informed my parents or the person's! e&ercising parental authority o#er my

 person of the nature of the acti#ity $hich I am joining and had secured their consent for my

 participation in the same. I li"e$ise secured their ad#ise on the measures $hich I am to

underta"e for my personal safety and security in relation to my participation in the said

acti#ity%

f! I hereby agree to $ai#e any responsibility on the part of AMA in relation to any

unto$ard incident $hich may happen to me during the said internship training, unless the

said loss, damage, injury or accident arose from the direct act or gross negligence of AMA.

 ___________________________ Signature of Student

 ____________________ 

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