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LETTER OF UNDERTAKING I, _________________ __________________, Age: ___ Yrs.

, student of ____________ _______________________ ____________________ _________________ , [a constituent of Symbiosis International University, do hereby declare and undertake as follo s: !. I am "ursuing _______________ ith __________________. At the time of admission, the Institution had arranged for a detailed Induction #rogramme. $. %uring the admission "rocess, I have been e&"lained the disci"linary rules of the Institution and I have understood the same. I as also made a are of the 'ode of 'onduct, Academic (ules, )&amination (ules, %ress 'ode, *ibrary #olicy of the Institute and I have understood the same. +. As a student I understand and agree that I have ,oined this University for academic "ursuits and for holistic develo"ment of my "ersonality. I agree that University and or Institution and-or its Authori.ed (e"resentatives have no control on activities, hich are not related to course curriculum and in hich I decide to engage myself voluntarily. It also sometimes ha""ens that during the course of "erforming authori.ed activities, students engage in activities on hich there is no direct indirect control of the authorities of the University - Institution. /. I also understand that as a res"onsible student of the University I should not engage myself in activities hich may cause in,ury to my "erson or "ro"erty. In case, any in,ury is caused to my "erson - "ro"erty due to my involvement - engagement in any manner in any activity, hich is not authori.ed by the University and - or Institution or on hich University and - or Institution does not have any direct - indirect control, hich may or may not be during the course of "erforming authori.ed activities like "artici"ation in s"orts events, "resentation, study e&cursion tour, "resentation, out bound "rogram, etc., then I am the "erson solely liable to bear its conse0uences. I undertake that I shall not hold the University - Institution liable in any manner hatsoever for the same. 1. Symbiosis also "romotes s"orts, because it believes in the "rinci"le of 2sound mind in sound body3. 4he "artici"ation in regular s"orts features or tournaments is com"letely voluntary. 5. I am ell a are that any s"orts event has some inherent risks involved in it. I am also a are hile "laying some s"orts some accidents may be caused. 6o ever, since my

"artici"ation to regular s"orts features of the Institute - University or any s"ecific tournament is com"letely voluntary, I shall not make any claim any amount as com"ensation or other ise due to any in,ury caused to "erson or "ro"erty arising out of my voluntary "artici"ation. 7. %uring the "rocess of induction - admission "rocess the students ere also informed that that Symbiosis 'entre of 6ealth 'are 8S'6'9 has establishment on the 'am"us here the students can avail :irst Aid :acility. I therefore understand that S'6' is res"onsible only for "rimary medical assistance and any higher degree of medical care or any medical emergency ill be addressed by referral to s"eciali.ed centers. ;. I also understand that in case of a medical "roblem, certain medical "rocedures may need to be "erformed by hos"itals to treat the <edical conditions. In such cases, as decided by the doctor, consent is re0uired to "erform the re0uired medical "rocedures. Any delay in "roducing the consent may "rove to be fatal and under any circumstance, medical treatment should not be delayed for ant of consent from my "arents- guardian. =. I therefore, in my interest, authori.e the Symbiosis International University and -or the Institution and-or any "erson designated by the University -Institution, to give consent for me and on behalf to "erform the medical "rocedures. I shall stand by this authori.ation and shall not hold Symbiosis International University and -or the Institution and-or any "erson designated by the University - Institution res"onsible liable for giving consent. !>. Symbiosis has insured each student to meet medical e&"enses u"?to (s. 1>,>>>-?in case of non accidental emergencies 8as "er the <ediclaim Insurance #olicy9 @ (s.!,>>,>>>-? in case of (ail-(oad 4raffic accidents. Aut it may ha""en that in some cases 8e&clusion clauses9, the insurance "olicy may not be honored. 6ence the University-Institution may have to incur certain e&"enses. I and-or my "arents undertake to "ay the total amount ithin !1 days of demand by the University Institute. !!. I have signed this Undertaking and authori.ed Symbiosis International University and -or the Institution and-or any "erson designated by University -Institution to give consent for medial "rocedure on my free ill and ithout any influence - "ressure from any "erson. 6ence this Undertaking and Authori.ation.

#lace: %ate: ________________________ Signature of the Student