Far Eastern University

Institute of Arts and Sciences

Department of Psychology
Manila, Philippines

Date:

WAIVER

I, ,parent of

Allow my son/daughter to participate in a research investigation in their chosen respective field of

endeavor in conducting Field Study as a part of the requirements in PSY 105 Experimental Psychology.

I undertake not to hold Far Eastern University or any of its officers or administrators liable for any damage
or injury which may be suffered by my son/daughter or caused to third persons by any act attributable to
the negligence or culpable act of my son/daughter or any third person.

This waiver has been signed voluntarily, fully aware of my right under the law.

With my parental consent,

Parents signature over printed name

FEU/ QSF IAS. 12 Rev. No. 00 Effectivity Date: 01 Aug 2005