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7/16/2019 6 - Parent's Waiver Form
http://slidepdf.com/reader/full/6-parents-waiver-form 1/1
DE LA SALLE UNIVERSITY
Psychology Department240 Ta!t A"en#e$ %an&la
PARENT'S (ERTI)I(ATI*N *) +AIVER )*R PSY(,*L*-Y PRA(TI(U%
Term 1, 2015-2016
To whom this may concern:
This is to certify that I am allowing my daughter, Marizza eyes, to do !racticum wor" at #hili!!ine
$eneral %os!ital, one of the !racticum sites a!!ro&ed 'y the #sychology (e!artment starting on the 1stTerm, 201)-2015*
It is understood that +he will a'ide 'y the rules and regulations set 'y the !racticum facultycoordinator, who is tas"ed with closely monitoring the !racticumers !rogress*
hile I ha&e 'een assured that !re&ious !racticumers assigned to &arious sites ha&e safelycom!leted their assigned tas"s, I fully agree to wai&e any res!onsi'ility on the !art of (e .a /alleni&ersity and the !sychology de!artments faculty coordinator, in case of any untoward incident that mayha!!en to my daughter in the course of fulfilling the reuirements for !racticum*
Marizza eyes #rinted 3ame of /tudent /tudents /ignature+(ate
4liza'eth eyes #rinted 3ame of #arent #arents /ignature+(ate
Maria ndrea /* Tirazona, M*/* #rinted 3ame of aculty 7oordinator aculty 7oordinators /ignature+(ate
38T4( 9:
(r* .aurene 7hua-$arcia 7hair, #sychology (e!artment