CONSENT FORM FOR Classes IX to XII

Dear Madam
My ward ………............................................................... Admission number……………………,
resident of (full address) …………………………………………..….studying in class.................
section ………........would be attending school on …......................... (Date of attending).

I consent and undertake that:

1. The offline classes for students of Class IX to Class XI will start after all the papers of Periodical Test
-3/ Unit Test - 2 are over.
2. We are NOT residing in a containment zone as defined by the government from time to time and as
applicable as on date.
3. I will ensure safe and secure transportation of my ward to and from school as there will be no
conveyance provided by school.
4. I will ensure that my ward follows all COVID safety norms prescribed by the government and
the school.
5. No member of our family is currently suffering from COVID or is under quarantine as on
date.
6. In case my ward is reported to have developed any symptom/s related to COVID during his/her stay in
school, I authorize the school officials to keep my ward quarantined and I shall immediately reach
school to pick up my ward back from school as soon as the school authorities inform me/us.
7. I authorize the school authorities to take suitable action against my ward in case he/she does not follow
COVID safety norms prescribed by the school.
8. My ward will attend school in proper school uniform wearing a mask and I- card of the previous class.
9. My ward shall report in time.
10. My ward will bring his/her own books/stationery/notebooks as borrowing is strictly prohibited.
11. My ward will carry his own snacks and a water bottle.
12. My ward will carry a personal hand sanitizer and an extra mask.
13. My ward will occupy only the seat allocated in class by the teacher and maintain social distancing
norms.
14. My ward will not carry mobile phone to school.

I further undertake that this consent is being given of my free will and I shall not hold the school
responsible for any infection or other untoward incident during the conduct of offline sessions in the
school premises.
I have read the circular for the reopening of school for my ward.
Thanking you,
Yours sincerely
Signature: ................................................................ Name of father/mother: ...........................................
Contact number of parent/ guardian:................................. Emergency phone
number:........................................ Date : .......................................................................