INDEMNITY BOND

( An undertaking given by the parent/ward of the student of the polytechnic)

This undertaking is given by Sri/Smt____________________________________ aged______years Parent of

Sri/Kum______________________________________ aged_______ years,PIN: __________________________________

Resident of ___________________________________________________________________________________________________

On this ___________________________day of ____________________________________________________

My son / daughter / ward has been admitted into the 3 year Diploma Course at___________________

Polytechnic,________________________.The duration of the course is 3 years of theory and practical. Out of three years of

study 2 ½ years at the Institution and 6 months in the Industry for acquiring hands on experience. The curriculum of the course

comprises of the participation of the students in the Work-Shops/Labs/Industry/Organisations/Field-Works/sports

activity/Industrial exposure/NCC/NSS etc., as curricular and extracurricular activities.

In the course of participation in such of these activities the students are likely to sustain injuries. Sometimes serious

mishaps may also occur endangering life of the student for which either the Polytechnic/Institution or the Technical Education

Department/Concerned Indutry/Organisation/Corporation not at all responsible and the students are not entitled for any damage

or compensation.

I also abide the safety guidelines given by the Principal which were prepared by the National Safety Council, India and

my son/daughter/ward shall follow all the guide lines for safety when they are in the work-

shops/Labs/Industry/Organization/Field work etc. applicable. Also, my son/daughter/ward has already attended the orientation

classes conductedon safety aspects at the polytechnic before they went to the work-shops/Labs/Industry/Organization/Field

work etc. applicable.

As my son/daughter/ward has already been covered INSURANCE by the _____________________Insurance Co. hence,

I therefore, undertake not to claim any damages or compensation either from the Polytechnic/Institution or Technical Education

Department/ Concerned Indutry/Organisation/Corporation in case I/my son/my daughter/my ward sustain(s) any injury or involve

in any untoward or unexpected mishap during the course of study and Industrial attachment for 6months in the final year. We

are giving this undertaking voluntarily without any force or coercion.

1.Signature of the Parent

( Name in Block Letters )

I am abiding the above

2. Signature of the Student
( Name in Block Letters )
Signature of the Witness with addresses Signature of the Principal
1.

2.