UNDERTAKING FROM STUDENT

(“Personal responsibility pledge by student for coming to campus”)

I ____________ , Student of ____________

Branch, with MIS No. _________________ confirm the following information, and undertake the following pledge,
regarding my arrival at IIIT Pune Campus.

1. I have completed both the doses of my vaccination and possess a certificate for the same.
2. I have been medically insured and can proffer the evidence for the same.
3. The Institute authorities shall not be in any way responsible/liable for any infection/illness/other
inadvertent situation which may be sustained by me at any time in the college or while commuting to
and from the college or while taking part in sports, during excursion, during sightseeing, or any other
extra-curricular activities or on account of any other reason whatsoever causing directly or indirectly
loss/injury.
4. I will observe COVID specific precautions during my stay in the IIIT Pune campus.
5. The Institute can take appropriate disciplinary action against me in case I flout any COVID rules
during my stay at the IIIT Pune campus.
6. I promise to cooperate with the Institute for smooth running of academic activities.
7. I will leave the hostel/Institute campus immediately with bag and baggage, in case shut downs are
ordered by the Government of India/State Government/University due to outbreak in campus or the
surrounding region/area.
8. I understand that ‘Spitting’ is a punishable offence; hence if I violate, I may be punished by the
Institute.
9. I shall bring my own masks, sanitizers and a thermometer for monitoring body temperature for
personal use. Further, I shall bring tooth paste, soaps/shampoo, shaving kits, blades, hair oil and other
items of general use from home, so that it can be utilized during my initial period of my stay.
10. I will use face covers/masks and other protective measures at all times while visiting to academic
blocks/ departments/ administrative offices, research laboratories, libraries and hostel’s common
places/areas like- dining hall/common room/reading room and at all places inside the campus.
11. I understand that in the hostel I have to share common room/washrooms, and dining facility, etc.
Therefore, I shall take necessary care all the time by diligently following all
instructions/notices/protocols in the hostel.
12. When joining the institute, I will make sure that I am not having high fever, dry cough, headache, sign
of breathlessness, loss of taste and smell problem.

That the above undertaking is voluntary and with my free will and consent.

Date: Place: _____

Signature of student