Consent cum Declaration Form for Industrial Visit Cum RRC

Shiv kumar Tayal

I, ……………………………………………………………………….[Guardian's Name], residing at
………………………………………………………………………………………………………………[G
uardian's Address], hereby provide my consent for my ward,
……………………………………………………………………. [Student's Name], a student of
Institute of Chartered Accountants vide registration number......................................................, to
participate in the 3- days , 2 nights trip to Jim Corbett organized by the Ghaziabad Branch of CICASA
of the Institute of Chartered Accountants of India on 28th - 30th June 2024. I understand and agree to
the terms and conditions outlined below, and acknowledge that my ward's participation in the trip is
subject to these conditions:

1. I understand that the trip will take place from 28th June2024 to 30th June 2024 and will involve
various activities, including Jungle Safari , Nature Walks, and Industrial Visit.

2. I acknowledge that my ward will be under the supervision and guidance of the authorized
representatives of the Institute of Chartered Accountants of India throughout the duration of the
trip.

3. I authorize the representatives of the Institute to take all necessary measures for the well being,
safety, and medical care of my ward in case of any emergency or unforeseen circumstances. I
understand that every effort will be made to contact me in such situations.

4. I accept that the Institute of Chartered Accountants of India, its representatives, and the trip
organizers will not be held responsible or liable for any injury, loss, damage, or accident that
may occur during the trip.

5. I understand that my ward will be expected to abide by the rules and regulations set forth by the
Institute and the trip organizers. I will ensure that my ward understands and follows these rules
and behaves responsibly throughout the trip.

6. I grant permission for my ward to be photographed or filmed during the trip for promotional or
educational purposes related to the Institute of Chartered Accountants of India. However, the
Institute will not use any personal information without seeking prior consent.

7. I agree to indemnify and hold harmless the Institute of Chartered Accountants of India, its
representatives, and the trip organizers from any claims, demands, actions, or liabilities arising
out of my ward's participation in the trip

I have read this consent cum declaration form carefully, and I fully understand and agree to its
contents. I hereby acknowledge that I have legal custody and authority to grant permission for my
ward's participation in the trip.

Guardian's Name:
Date:
Guardian's Contact Number:
Guardian's Email Address:
Signature:
Please return the signed consent cum declaration form to the Ghaziabad Branch of CICASA of the
Institute of Chartered Accountants of India.

Thank you for your cooperation.

Sincerely,

CA. Ankit Goel

Chairman- CICASA
ICAI-Ghaziabad
Email: cicasagzb2016@gmail.com