A F F I D A V I T OF C O N S E N T

I, ______________________________, of legal age, the son/ daughter of Mr. _______________

and Mrs.________________, residing at ____________________________________________,
voluntarily joins the out-of-campus activity of Benilde Antipolo Junior Marketing Association
[BAJMA], the year-end-convention of Philippine Junior Marketing Association [PJMA] entitled
7th MADWORLD: Unraveling the Art of Influence. Said event will be held at SM MOA
Arena, Mall of Asia Complex, Pasay City on Sunday, 24th day of February 2019 from 12:00pm-
6:00pm. Since the participants are expecte to be at the venue by 9:00am, the bus will leave at
exactly 6:00am from De La Salle-College of Saint Benilde Antipolo City. Expected departure
from SM MOA is 7:00pm and will arrive at DLS-CSBA by 10:00pm.

I understand that I voluntarily joined the group dynamics and I will be responsible of my own
actions. I will abide by the rules and regulations of the De La Salle-College of Saint Benilde
Antipolo Campus. Violation of any the guidelines set by the college will be subjected to
corresponding sanction.

I understand that it is with my purest intention to join the group dynamics. I acknowledge that I
will not seek to have the De La Salle-College of Saint Benilde Antipolo held liable in the event
that any accident, injury, loss of property or any other circumstance or incident occurs during or
as a result of my participation in the group dynamics.

This release of liability includes accident, injury, loss, or damages to the student, as well as, to
other individuals or property which may result from the student’s participation in the event. I
hereby release and agree to hold harmless the De La Salle-College of Saint Benilde Antipolo, its
officials, agents and employees, from any claims arising out of my son’s/daughter’s participation
in the event(s).

Conforme:

_________________________________________ ________________________
Student’s Signature over Printed Name Date

_________________________________________ ________________________
Parent’s/ Guardian’s Signature over Printed Name Date

Doc. No. _____

Page No. _____
Book No. _____
Series of _____

*Note: Notarized Affidavit of Consent is to be submitted to the BAJMA Moderator. Non- submission
would mean non- participation to the group dynamics activity.