BAL-BALIKA INDEMNITY

1. I, the undersigned, , bearer of South African Identity Number/Indian

Passport Number and parent/guardian/custodian of
(“the child”) hereby give permission for the child to participate in all activities,
excursions and tours organised by B.A.P.S Swãminãrãyan Sansthã, South Africa.

2. I hereby indemnify and exempt the B.A.P.S Sansthã, its volunteers and/or employees and/or related
persons (“the Sansthã”) from liability for, or injury, bodily harm to or death of the child, or any loss or
damage to the child’s property and loss of goods, occurring as a result of any accident or incident which
may take place whilst in the company of volunteers and/or employees and/or related persons of the
Sansthã.

3. In the event of any medical treatment of any nature being required in respect of the child, I hereby grant to
volunteers and/or employees and/or responsible persons in control, so mandated by the Sansthã, full power
to authorize any such treatment which he/she deems fit. I hereby accept full responsibility for payment of all
medical costs so incurred and all other costs incidental thereto. The authorization by the Sansthã
representative in terms of this clause will only apply, in the event of an emergency and when the
parent/guardian/custodian cannot be reached telephonically to attend directly to the medical instruction
required to be given, relating to the medical treatment necessary for the child.

4. I understand that this makes it essential that I as the signatory hereto, ensure that my current telephone
numbers in use, are always communicated to the Sansthã, to keep its records updated at all times. I further
hereby undertake to immediately advise the Sansthã of any changes to our contact telephone number/s so
that I can be contacted when medical treatment may be required to be given to the child.

5. I agree to the Sansthã’s use of images and videos of the aforementioned child, at its sole discretion. When
exercising this discretion, the Sansthã will seek to avoid impinging on the child's modesty or presenting the
child in a negative light. I also grant the Sansthã permission to use images for marketing purposes, or allow
external agencies to do so (as opposed to using pictures in Sansthã-related publications or other similar
media, or in the course of filming ordinary Sansthã activities.

6. I, the parent/guardian/custodian, by my signature hereto also acknowledge that I am the party entitled to
provide this information and issue this indemnity in respect of the child. Should it transpire that I am not the
responsible person to issue this mandate and indemnity, I by my signature hereto shall hold myself liable to
the Sansthã for the financial consequences flowing from the granting of this indemnity and instruction by
me, on my part, howsoever arising.

7. I hereby declare that the child suffers from the following pre-condition and/or cannot use certain types of
medication:

7.1. None
7.2. Mild condition or intolerance
7.3. Life threatening condition or allergy
7.4. Other- Specify

8. I understand and accept that whilst the Sansthã makes every endeavour to act in the best interests of the
child and ensure its safety at all times, the Sansthã is not held responsible, and cannot be held liable for any
event which may affect the child.

Signed on this the day of 2023 at .

Parent/Guardian Signature Witness Signature

Name: Name: