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RRJ Required Forms

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0% found this document useful (0 votes)
50 views10 pages

RRJ Required Forms

Uploaded by

Verjie bongcales
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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REGIONAL RESCUE JAMBOREE

2024

1 | Page
REGIONAL RESCUE JAMBOREE 2024

Annex A: LOCAL GOVERNMENT UNIT: SILAGO


METHOD OF TRAVEL SKILLS / CAPABILITIES WITH MANIFEST?
FULL NAME (TO AND FROM THEIR
NO. CONTACT DETAILS
(FIRST, M.I., LAST) HOMEBASE) YES NO

1 Team Leader: ALFIE C. ALMINE 09671394595 LAND √

2 GLEN L. CERENO, JR 09203419433 LAND WASAR √


3 DEXTER E. DAVID 09125449727 LAND WASAR √

4 KIM MART G. ESMEDIA 09120596884 LAND WASAR √

5 IAN S. ESQUILLO 09319533143 LAND WASAR √

6 JUNE ANTHONY C. ISIP 09283497290 LAND WASAR √

7 JAIRO C. MESTIOLA 09358501407 LAND WASAR √

10

11

12

13

Registration Form
REGIONAL RESCUE JAMBOREE 2024

Annex B:

WAIVER AND RELEASE OF LIABILITY


I am voluntarily participating in the activities indicated in the Regional Rescue Jamboree (RRJ)
2024 at the Southern Leyte State Unitversity (SLSU) in the Municipality of Sogod, Province of
Southern Leyte, and nearby areas, on 02-09 July 2024 (inclusive of travel time) at my own
risk.

I am aware of the risks associated with traveling to and from, as well as participating in the
series of activities which may include, but are not limited to, physical or psychological injury,
pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis),
economic or emotional loss, and death.

I understand that these injuries or outcomes may arise from my own or others’ negligence,
conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume
all related risks, both known and unknown to me, of my participation in these activities.

I acknowledge that I have carefully read this “waiver and release” and fully understand that it is
a release of liability. I expressly agree to release and discharge OCD Regional Office VIII and
the Province of Southern Leyte from any and all claims or causes of action and I agree to
voluntarily give up or waive any right that I otherwise have to bring a legal action against the
aforementioned agency/PLGU for personal injury or property damage.

ALFIE C. ALMINE SILAGO


Signature Over Printed Name LGU

Approved by:

HON. LEMUEL P. HONOR


Local Chief Executive / Authorized Representative

July 02, 2024


Date Accomplished

Waiver Form
REGIONAL RESCUE JAMBOREE 2024

Annex B:

WAIVER AND RELEASE OF LIABILITY


I am voluntarily participating in the activities indicated in the Regional Rescue Jamboree (RRJ)
2024 at the Southern Leyte State Unitversity (SLSU) in the Municipality of Sogod, Province of
Southern Leyte, and nearby areas, on 02-09 July 2024 (inclusive of travel time) at my own
risk.

I am aware of the risks associated with traveling to and from, as well as participating in the
series of activities which may include, but are not limited to, physical or psychological injury,
pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis),
economic or emotional loss, and death.

I understand that these injuries or outcomes may arise from my own or others’ negligence,
conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume
all related risks, both known and unknown to me, of my participation in these activities.

I acknowledge that I have carefully read this “waiver and release” and fully understand that it is
a release of liability. I expressly agree to release and discharge OCD Regional Office VIII and
the Province of Southern Leyte from any and all claims or causes of action and I agree to
voluntarily give up or waive any right that I otherwise have to bring a legal action against the
aforementioned agency/PLGU for personal injury or property damage.

GLEN L. CERENO, JR SILAGO


Signature Over Printed Name LGU

Approved by:

HON. LEMUEL P. HONOR


Local Chief Executive / Authorized Representative

July 02, 2024


Date Accomplished

Waiver Form
REGIONAL RESCUE JAMBOREE 2024

Annex B:

WAIVER AND RELEASE OF LIABILITY


I am voluntarily participating in the activities indicated in the Regional Rescue Jamboree (RRJ)
2024 at the Southern Leyte State Unitversity (SLSU) in the Municipality of Sogod, Province of
Southern Leyte, and nearby areas, on 02-09 July 2024 (inclusive of travel time) at my own
risk.

I am aware of the risks associated with traveling to and from, as well as participating in the
series of activities which may include, but are not limited to, physical or psychological injury,
pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis),
economic or emotional loss, and death.

I understand that these injuries or outcomes may arise from my own or others’ negligence,
conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume
all related risks, both known and unknown to me, of my participation in these activities.

I acknowledge that I have carefully read this “waiver and release” and fully understand that it is
a release of liability. I expressly agree to release and discharge OCD Regional Office VIII and
the Province of Southern Leyte from any and all claims or causes of action and I agree to
voluntarily give up or waive any right that I otherwise have to bring a legal action against the
aforementioned agency/PLGU for personal injury or property damage.

DEXTER E. DAVID SILAGO


Signature Over Printed Name LGU

Approved by:

HON. LEMUEL P. HONOR


Local Chief Executive / Authorized Representative

July 02, 2024


Date Accomplished
REGIONAL RESCUE JAMBOREE 2024

Annex B:

WAIVER AND RELEASE OF LIABILITY


I am voluntarily participating in the activities indicated in the Regional Rescue Jamboree (RRJ)
2024 at the Southern Leyte State Unitversity (SLSU) in the Municipality of Sogod, Province of
Southern Leyte, and nearby areas, on 02-09 July 2024 (inclusive of travel time) at my own
risk.

I am aware of the risks associated with traveling to and from, as well as participating in the
series of activities which may include, but are not limited to, physical or psychological injury,
pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis),
economic or emotional loss, and death.

I understand that these injuries or outcomes may arise from my own or others’ negligence,
conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume
all related risks, both known and unknown to me, of my participation in these activities.

I acknowledge that I have carefully read this “waiver and release” and fully understand that it is
a release of liability. I expressly agree to release and discharge OCD Regional Office VIII and
the Province of Southern Leyte from any and all claims or causes of action and I agree to
voluntarily give up or waive any right that I otherwise have to bring a legal action against the
aforementioned agency/PLGU for personal injury or property damage.

IAN S. ESQUILLO SILAGO


Signature Over Printed Name LGU

Approved by:

HON. LEMUEL P. HONOR


Local Chief Executive / Authorized Representative

July 02, 2024


Date Accomplished

Waiver Form
REGIONAL RESCUE JAMBOREE 2024

Annex B:

WAIVER AND RELEASE OF LIABILITY


I am voluntarily participating in the activities indicated in the Regional Rescue Jamboree (RRJ)
2024 at the Southern Leyte State Unitversity (SLSU) in the Municipality of Sogod, Province of
Southern Leyte, and nearby areas, on 02-09 July 2024 (inclusive of travel time) at my own
risk.

I am aware of the risks associated with traveling to and from, as well as participating in the
series of activities which may include, but are not limited to, physical or psychological injury,
pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis),
economic or emotional loss, and death.

I understand that these injuries or outcomes may arise from my own or others’ negligence,
conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume
all related risks, both known and unknown to me, of my participation in these activities.

I acknowledge that I have carefully read this “waiver and release” and fully understand that it is
a release of liability. I expressly agree to release and discharge OCD Regional Office VIII and
the Province of Southern Leyte from any and all claims or causes of action and I agree to
voluntarily give up or waive any right that I otherwise have to bring a legal action against the
aforementioned agency/PLGU for personal injury or property damage.

KIM MART G. ESMEDIA SILAGO


Signature Over Printed Name LGU

Approved by:

HON. LEMUEL P. HONOR


Local Chief Executive / Authorized Representative

July 02, 2024


Date Accomplished

Waiver Form
REGIONAL RESCUE JAMBOREE 2024

Annex B:

WAIVER AND RELEASE OF LIABILITY


I am voluntarily participating in the activities indicated in the Regional Rescue Jamboree (RRJ)
2024 at the Southern Leyte State Unitversity (SLSU) in the Municipality of Sogod, Province of
Southern Leyte, and nearby areas, on 02-09 July 2024 (inclusive of travel time) at my own
risk.

I am aware of the risks associated with traveling to and from, as well as participating in the
series of activities which may include, but are not limited to, physical or psychological injury,
pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis),
economic or emotional loss, and death.

I understand that these injuries or outcomes may arise from my own or others’ negligence,
conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume
all related risks, both known and unknown to me, of my participation in these activities.

I acknowledge that I have carefully read this “waiver and release” and fully understand that it is
a release of liability. I expressly agree to release and discharge OCD Regional Office VIII and
the Province of Southern Leyte from any and all claims or causes of action and I agree to
voluntarily give up or waive any right that I otherwise have to bring a legal action against the
aforementioned agency/PLGU for personal injury or property damage.

JUNE ANTHONY C. ISIP SILAGO


Signature Over Printed Name LGU

Approved by:

HON. LEMUEL P. HONOR


Local Chief Executive / Authorized Representative

July 02, 2024


Date Accomplished

Waiver Form
REGIONAL RESCUE JAMBOREE 2024

Annex B:

WAIVER AND RELEASE OF LIABILITY


I am voluntarily participating in the activities indicated in the Regional Rescue Jamboree (RRJ)
2024 at the Southern Leyte State Unitversity (SLSU) in the Municipality of Sogod, Province of
Southern Leyte, and nearby areas, on 02-09 July 2024 (inclusive of travel time) at my own
risk.

I am aware of the risks associated with traveling to and from, as well as participating in the
series of activities which may include, but are not limited to, physical or psychological injury,
pain, suffering, illness, disfigurement, temporary or permanent disability (including paralysis),
economic or emotional loss, and death.

I understand that these injuries or outcomes may arise from my own or others’ negligence,
conditions related to travel, or the condition of the activity location(s). Nonetheless, I assume
all related risks, both known and unknown to me, of my participation in these activities.

I acknowledge that I have carefully read this “waiver and release” and fully understand that it is
a release of liability. I expressly agree to release and discharge OCD Regional Office VIII and
the Province of Southern Leyte from any and all claims or causes of action and I agree to
voluntarily give up or waive any right that I otherwise have to bring a legal action against the
aforementioned agency/PLGU for personal injury or property damage.

JAIRO C. MESTIOLA SILAGO


Signature Over Printed Name LGU

Approved by:

HON. LEMUEL P. HONOR


Local Chief Executive / Authorized Representative

July 02, 2024


Date Accomplished

Waiver Form
REGIONAL RESCUE JAMBOREE 2024

Annex C:

LOCAL GOVERNMENT UNIT: SILAGO

QUANTITY/UNIT
EQUIPMENT/MOBILITY/CAPABILITY USED FOR (WASAR,
NO. REMARKS
(Pls. specify) MoSAR, etc.)

1 Rescue Vehicle/ Patient Transport Vehicle 2 Mobilization

2 Fiber Spine Board 2 Mobilization

3 Kendrick Extrication Device KED 1 Extrication/MOSAR

4 Rope Rescue/Rappelling 1 set MOSAR

5 Life vest Type III 15 pcs WASAR

6 Rescue Tubes 4 pcs WASAR

7 Rescue Can 2 pcs WASAR

8 Life Rings 6 pcs WASAR

9 Snorkel 2 sets WASAR


Googles
Scuba diving fin/pads
Diving shoes/booties
Full body wet suit
10 Megaphone 1 pc Communication

11 Handheld Radios 8 pcs Communication

12

13

14

15

Note: All responders should declare capability to the RRJ-


TWG
Capability Equipment

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