COVID-19 CONSENT AND INDEMNITY FORM

(This document contains 03 printed pages)

Name of the Parent/Legal Guardian

I, __________________________________ Name of the Student
father/legal guardian of ____________________________
Adm.No.
Admn. No. _______________ Class
Class ___________, a Student of Taurian World School, Ranchi,
acknowledge the contagious and unpredictable nature of the coronavirus disease (COVID-19) and I
hereby execute this COVID-19 Consent and Indemnity Form as per the school policy.

I understand that the School has put in place preventive measures and other protocols to minimize the
Name of the Student
spread of COVID-19 but, even so, _________________________________’s return to the School may
subject him/her to the risk of being infected. It is however well known that the COVID virus is ubiquitous
in the atmosphere all over India. So, the risk of exposure is everywhere whether in School or at home or
in the market or anywhere else. However, the School will endeavour to maintain high standards and
keep the School as a controlled entry zone so that the School offers less risk to potential exposure than
any other place.
Name of the Student
I also understand that _________________________________ is under no obligation to attend the
School if I and/or the Student have any safety concerns.

Name of the Student

Notwithstanding this, I have freely consented to _________________________________’s return to the
School fully aware of, and on the voluntary assumption of, the aforementioned risk.

Name of the Student

I undertake to follow, and to impress on _________________________________ to follow, all
instructions and requirements of the School as they may be amended by the School due to the School’s
response to the COVID-19 pandemic to limit any transmissions of COVID-19; and as required by any
Regulations issued by the Government under the Disaster Management Act, 2005 (Act No. 53 of 2005).

I hereby agree to unconditionally indemnify and hold harmless the School against any claim for damages
or expenses and/or from any other claims, costs or other liability or expense of any nature whatsoever
(whether direct, consequential or otherwise for any causality sustained by the Student), arising out of or
in connection with the transmission of COVID-19 at School.

I hereby unconditionally, waive and discharge any and all claims, suits, or proceeding that I, or the
Student, may have against Taurian World School, Ranchi with respect to casualty, arising out of,
resulting from, and relating to or in connection with the transmission of COVID-19 at School.

While the School will use realistic endeavors to limit Student to Student and Staff to Student physical
contact, there will be instances where contact is made between Students while Students adapt to the

Name and Signature of the Parent

new guidelines and/or when Students need to be comforted and assisted by staff. I agree that it will not
be possible for the School to guarantee that this contact will not occur with children on site.

I understand this is an important legal document indemnifying the School against the transmission of
COVID-19 on the School’s premises and that by signing this Indemnity I hereby waive legal rights that
may exist and that I may otherwise have against the School and others.

NAME OF PARENT / LEGAL GUARDIAN: ________________________________________________________

RELATIONSHIP WITH THE STUDENT: ___________________________________________________________

PERMANENT ADDRESS: _____________________________________________________________________

_________________________________________________________________________________________

PRESENT ADDRESS: ________________________________________________________________________

_________________________________________________________________________________________

MOBILE NO: ______________________________________________________________________________

TRAVEL HISTORY OF THE STUDENT (DOMESTIC & INTERNATIONAL) PRIOR TO ARRIVAL IN THE SCHOOL:

_________________________________________________________________________________________

TRAVEL HISTORY OF THE FAMILY (DOMESTIC & INTERNATIONAL) PRIOR TO ARRIVAL IN THE SCHOOL:

_________________________________________________________________________________________

HISTORY OF COVID INFECTION OF THE STUDENT: ________________________________________________

HISTORY OF COVID INFECTION OF THE FAMILY: __________________________________________________

HAS YOUR SOCIETY/AREA/COLONY EVER BEEN IDENTIFIED AS A CONTAINMENT ZONE? IF YES, PLEASE
GIVE THE TIME PERIOD PRIOR TO ARRIVAL IN THE SCHOOL:

_____________________________________________________________________________________

Name and Signature of the Parent

I/WE DO HEREBY DECLARE AND CERTIFY THAT I/WE HAVE READ THIS DOCUMENT AND I/WE FULLY
UNDERSTAND ITS CONTENT. I AM / WE ARE AWARE THAT THIS IS AN INDEMNITY AND RELEASE OF
LIABILITY AND I/WE SIGN IT OF MY OWN FREE WILL.

Signed (Parent / Guardian’s signature): ______________________________________________

DD/MM/YYYY
Date: _______________________________________

* The governing law and alternative dispute resolution provisions of the Parent Contract (as amended
from time to time) shall apply mutatis mutandis to this Indemnity.

DD/MM/YYYY
Accepted by the School on Date: ___________________________

PRINCIPAL

Note:
(Submission of hard copy of this Indemnity Form is mandatory while visiting the school failing which the
child will not be allowed inside the campus)

Name and Signature of the Parent