CoRAzoN c. RUBIo, cEso vr - republic of the philippines division of ...

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. Philippine Amateur S€paktakraw.Association, Inc. REGISTRATION T€am Address: Moblle.No: 'Landlino: EmailAddress:, Team Manage( Coacb: , Ladii!6 i en: Name-. Age: _ Birthdav: Ni,n", f99,-_ Bifthday: _ Narle: .. l - Philippine Anateur S€pak Takraw.Associatiotr Inc. (PASTA) ,i\ddr€ss: G/I Bldg. B Philippine Sports Commission ULTRA Sports Complex, Pasig Cily Email: !"1' t':'-,tr ir!-' Mobile: 0917.8115714
READ BEFORE SIGNING Philippine Amateur Sepaktakraw Association, Inc. PASTA WAIVER ANO RELEASE OF LIABILITYD ln considerafion of being allowed to parlicipate in any way in THE PHILIPPINE AI'ATEUR SEPAK TAKRAW INC (PASTA) sports program, related events and aclivities, the undersigned acknowtedges, appreciates, and agrees that: 'l) The risk of injury from fhe activities involved ln thig program is significant, including the potential for permanent paralyEig and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2) I KNOWNGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unKnown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES oT others. and assume full responsibility for my participalion; and. 3) I willingly agree to comply with the stated and cuslomary l€rms and conditions for participation. lf, however, I obseNe any unusual significant hazard during my presence or participation, I will remove myself from partjcipation and bring such to the atlenlion ofthe nearest official immedhtelyi and, 4) l, for myself and on behalf of my heirs, assigns, personal repr€sentatives and nexl of kin, HEREBY RELEASE AND HOLO HARMLESS PHlLlPPll{E A'IATEUR SEPAK TAKMW INC (PASTA) their officers, offlcials, agents, and/or employees, other perticipants, sponsodng agencies, sponsors, advertisers, and if applicable, owners and lessors of premis€s used to conduct th6 event ("RELEASEES"), WjTH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSU PTION OF RISK AGREEMENT, FULLY UNDERSTAI{D ITS TER'/IS, UNDERSTAI{D THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WlTHOUT ANY INDUCEMENT. DATE SIGNED: Team Name: (Ieam Manage/s Name & Signature) Philippine Amateur Sepak Trkraw Associrtion Inc. (PASTA) Address; CF Bldg. B Phiiippine Sports Commission ULTRA Sports Complex, Pasig Ciiy Email: f. i'i.: f :i j1't i rir'!,,,:.-i.ril r,u Mobile:0917.8115714
Page 1 and 2: MEMORANDUM TO: R.plrbllo ol llrr Ph
Page 3: For quGdons and conoerns rcgardhg t
Page 7: Course: (Please chsck) Philippine A

CoRAzoN c. RUBIo, cEso vr - republic of the philippines division of ...

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