VPS/ADM/21-22/Parent Consent - Offline classes for Class VI to XII/201021 20th October, 2021

PARENT CONSENT FORM FOR SENDING STUDENTS TO ATTEND

CLASSES AT THE SCHOOL

We the parents of _____________ studying in

class/sec ____ at your school have read and understood that as per the directions of the
Department of Education, Government of Karnataka, the school can start classes for its
students. We have also read and understood the guidelines and precautions taken by the
school.

We voluntarily agree and consent to send our child to the school to attend classes.

We hereby declare the following:

1. Our child does not have any symptoms of cold / cough / fever or any other Covid 19
symptoms.
2. We fully understand and agree that despite all safety precautions taken by the school,
the school cannot be held liable / responsible for any infection that may be caused.
3. We fully understand / agree to undertake all responsibility for the safe transport of our child
to and from the school.
4. We fully understand / agree and we shall instruct our child to mandatorily
a) wear a face mask at all times and maintain the prescribed social distancing as
specified by the health department.
b) not share any belongings / food items / etc. with any peers / others.

Name of Father : Signature of Father :

Name of Mother : Signature of Mother :

Date :

Place :