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  • SD - College Undertaking Form2

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    Krutika rankhambe
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    The document is a consent form from a student attending Smt. Sushiladevi Deshmukh College of Art’s, Science & Commerce in Navi Mumbai. The form collects the student's personal details and vaccination status. It also outlines that the student agrees to follow all COVID-19 safety protocols on campus and will not hold the college responsible if infected, despite precautions. The student and parent signatures are required at the bottom of the form to acknowledge understanding.

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    Understaking

    Original Title

    SD.College-Undertaking-form2

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    The document is a consent form from a student attending Smt. Sushiladevi Deshmukh College of Art’s, Science & Commerce in Navi Mumbai. The form collects the student's personal details and vaccination status. It also outlines that the student agrees to follow all COVID-19 safety protocols on campus and will not hold the college responsible if infected, despite precautions. The student and parent signatures are required at the bottom of the form to acknowledge understanding.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    6 views1 page

    SD - College Undertaking Form2

    Uploaded by

    Krutika rankhambe
    The document is a consent form from a student attending Smt. Sushiladevi Deshmukh College of Art’s, Science & Commerce in Navi Mumbai. The form collects the student's personal details and vaccination status. It also outlines that the student agrees to follow all COVID-19 safety protocols on campus and will not hold the college responsible if infected, despite precautions. The student and parent signatures are required at the bottom of the form to acknowledge understanding.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Smt.

    Sushiladevi Deshmukh College of Art’s, Science & Commerce


    Sector-04, Airoli, Navi Mumbai-400708

    CONSENT / UNDERTAKING FORM FROM THE STUDENT

    I, Mr./Ms
    son/ daughter of Mr./Mrs._________________________________

    Mobile No. Email Address:

    Residential Address:____________________________________________
    I declare that..

    I have taken 1st dose

    I have taken 2nd dose

    I am below 18th I have not taken any dose

    I agree that:

    1. I am aware of covid-19 situation.

    2. I will follow all safety protocols prescribed by the college.


    3. Inspite of all safety measures if I get infected, College authorities will not be
    held responsible.
    Class:___________ Roll No. ________________

    Signature of Student: ________________

    Signature of Parent: ___________________ Mobile No.__________________

    Date:

    Place:

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