PRAMAAN PATRA

I _______________________ Parent of _______________________, Class and Section

__________________, confirm the following :

a. There is no Covid symptomatic member in our family.

b. My ward is not suffering from COLD, COUGH OR FEVER.
c. I will arrange to pick & drop my ward to and from school.
d. At school, my ward would follow social distancing and necessary precautions as directed.
Signature: Date:
Name of the Parent :
e. I will not hold the school responsible in case my child catches any infection.

Signature:
Date:
Contact No.:
PRAMAAN PATRA

I _______________________ Parent of _______________________, Class and Section

__________________, confirm the following :

a. There is no Covid symptomatic member in our family.

b. My ward is not suffering from COLD, COUGH OR FEVER.
c. I will arrange to pick & drop my ward to and from school.
d. At school, my ward would follow social distancing and necessary precautions as directed.
Signature: Date:
Name of the Parent :
e. I will not hold the school responsible in case my child catches any infection.

Signature:
Date:
Contact No.:
PRAMAAN PATRA

I _______________________ Parent of _______________________, Class and Section

__________________, confirm the following :

a. There is no Covid symptomatic member in our family.

b. My ward is not suffering from COLD, COUGH OR FEVER.
c. I will arrange to pick & drop my ward to and from school.
d. At school, my ward would follow social distancing and necessary precautions as directed.
Signature: Date:
Name of the Parent :
e. I will not hold the school responsible in case my child catches any infection.

Signature:
Date:
Contact No.: