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

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

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Philippine Amateur Sepsktskmw Association, Inc.<br />

. FOR PARTICIPANIS OF MNORITY AGEE<br />

(UNDER AGF I8 AT THE TIIII|E OF REGISTRATION}<br />

Thls is to certify thal l, as parenyguardian <strong>of</strong> With legal<br />

responsibility for this participant, do consent and agree to his/her release as provided<br />

above <strong>of</strong> all <strong>the</strong> Releasees, and for myself, my heirs, assigns, and next <strong>of</strong> kin, I<br />

release and agree to indemnify and hold harmless <strong>the</strong> Releasees from any and all<br />

liabilities incident to my minor child's involvement or participation in <strong>the</strong>se progEms<br />

as provided above, EVEN lF ARISING FROM THEIR NEGLIGENCE, to <strong>the</strong> fullest<br />

extent permitled by law.<br />

DATE SIGNED:<br />

(Parenucuardian/Team Manager Name & Signature)<br />

Emergencl Phone Number:,( )<br />

Philippirc Amaletrr S€psk Takrsw Associttion lnc, (PASTA)<br />

Address: C/F Bldg. B Philippine Spor'ts Commission ULTRA Sports Complex, Pasig<br />

City<br />

Email: llll!-j-ra.i.tl,-i!1I::tj!u|t i.:'It!<br />

Mobile:0917.8115714

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