UNDERTAKING FROM PARENT

I, ________________________________________________, parent of _________________________________________,

a student of Course_____________________________________ in Axis Institute of _______________________,
declare that I have no objection to my Son/Daughter voluntarily going to College to attend classes, as scheduled by the
College, during the period beginning December 01, 2020.

I fur ther declare that

1. I understand the risks of COVID-19 transmission which exist in the prese nt situation.

2. My son/daughter is maintaining good health and is not suffering from any illness ( fever, cough and breathing problem)
at the moment and during last 2 weeks.

3. My ward is not having any disease like diabetes, hyper tension or hear t/ lung /kidney related disease, etc.

4. My ward will regularly wash his/her hands with soap and water for at least 20 seconds or clean them with alcohol
based sanitizer.

5. My ward will wear face mask as well as any other prescribed protective gear and maintain physical social distancing
in hostel , mess and class rooms and college campus .

6. My ward will use Aarogya Setu App on my mobile and it will remain active at all times (through Bluetooth and Wi-Fi)

7. I will not send my ward to the College if he/she is unwell and displays any symptoms like cough, fever, difficulty in
breathing and bodily weakness.

8. I wil immediately inform the College authority and the State Health authorities if any signs of illness appear in my ward.
9. I also want to declare that College authority has not put any pressure on me to send my ward for physical/offline
classes.

10. I will be available at shor t notice on my mobile no. to receive any information from the College if my ward
becomes unwell while he/she is in College.

Signature of student: Signature of parent:

Signature of Witness:

Date: Date: