Republic of the Philippines

Department of Environment and Natural Resources

PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
2/F Lysa Queen Bldg. Mc Arthur Highway San Pablo, Malolos, Bulacan
Telefax No.: (044) 794-7090 Email Ad.: denr_bulacan@yahoo.com

WAIVER AND RELEASE FROM LIABILITY

I am ________________________, of legal age, team leader/representative of

the hikers listed on the second page, fully understood the risk of mountaineering and
oriented the team on the basics of mountaineering, responsibly take all the
responsibilities as the organizer of the hike at Mt. Maranat on _______ ___, 2017.

As the teams leader/representative, I and my team hereby release and

discharge the Department of Environment and Natural Resources-Bulacan from
any liability that may arise from any form of accidents/injuries, illnesses, losses,
damages, claims, or expenses of any kind as a result of the permission they granted us
in hiking/climbing Mt. Maranat.

COMMITMENT

As DENR Bulacans partner in environmental preservation and conservation, we

commit to:

____ Conduct tree planting activity

____ Conduct clean-up activity
____ Donate Seedlings
____ Donate Seedling Bags
____ Others: (Please specify) __________________________

Number of Seedlings/bags:___________________
Tree species: _______________________________________
Contact Person in the area: _______________________________
Location where you intend to plant seedlings: ___________________________

I agree to submit post-climb report on ___________ ____, 2017.

_____________________________
Signature of Teams Representative
Contact No.:___________________
Date: ________________
 Republic of the Philippines
Department of Environment and Natural Resources
PROVINCIAL ENVIRONMENT AND NATURAL RESOURCES OFFICE
2/F Lysa Queen Bldg. Mc Arthur Highway San Pablo, Malolos, Bulacan
Telefax No.: (044) 794-7090 Email Ad.: denr_bulacan@yahoo.com

CONFORME: (Note: All the hikers should sign the waiver)

NAME OF HIKERS CONTACT NO. SIGNATURE