Mandatory Self Declaration for Parents

Date: Click here to enter a date.

Dear Parents,
Safe and Healthy Greetings.
In the wake of the surge of Covid 19, Podar Jumbo Kids endeavours to safeguard children under our care. We intend
to re-open our Podar Jumbo Kids Kindergarten/Podar Jumbo Kids Day care facility on (date) Click here to enter a
date. as per the guidelines issued by the Government but require certain important information from your end at
this delicate hour.
As part of precautionary measures to ensure the health and wellbeing of children in our preschools, we request
parents to provide travel declarations for their children at their respective centre. Families who have travelled
overseas or within India or have returned from overseas or any part of India in the past 14 days, should declare their
travel history to us promptly. This also means that any preschool child returning from an outstation visit should not
attend preschool/daycare for 14 days from the date of their return, as a precautionary measure.
Please take note that all declared information will be kept strictly confidential.
Child’s Name: prabhav shenoy
Father’s Name: nagesh shenoy
Contact Number: 6361920981
Email Address: nageshshenoy1984@mail.com
Mother’s Name: vijetha kini
Contact Number: 9844677762
Email Address: vijikini@mail.com
Date: 1-12-2021
I declare that:
1. I have not travelled to any country/or city in the past 14 days from this declaration date.
2. If yes, I have travelled to Click here to enter text. on Click here to enter text.
3. I have not been in contact with a confirmed / suspect Covid-19 case in the last 14 days.
4. I do not have a temperature of more than 38.0 degree Celsius (please put this in Indian format, we don’t use
Celsius) or any respiratory symptoms such as cough, flu and shortness of breath / difficulty in breathing.
5. I understand the purpose of this declaration and hence I will not report to work at Podar Jumbo Kids/ Podar
Jumbo Kids Day care Kindergarten if any of the family members is having fever or respiratory symptoms.
I also confirm that the information provided is true at the time of submission.
Mother’s Name: vijetha kini

Mother’s Signature:
Father’s Name: nagesh shenoy

Father’s Signature:
Date: 1-12-2021
Place: mangalore