STUDENT DECLARATION / UNDERTAKING / INDEMNITY BOND

I, Mr./Ms. aged am a student of

Alliance University bearing a Registration number studying in Semester
of Course, _______________ S/o.|D/o.
having a permanent residential address

do hereby undertake on this ______________________ (day & month) of ____ __________ (year) as follows:

1. I hereby declare that I, on my own, intend to take part in the event to be held at

2. I hereby declare that I have informed my parents about my participation in the above-said event and they have
given their assent without any demur to attend the above event.

3. I hereby declare that the certificates produced by me especially pertaining to my age proof and
SSLC/PUC/Degree certificates are genuine.

4. I hereby declare that I am aware of potential risks of injury including, but not limited to accidents and other
serious hazards that are involved in taking part in the above-said event. I shall not hold the University, officials
representing the University for any of the mishaps/accidents/injuries that might occur.

5. I hereby declare that I shall not involve in any of the activities which will bring disrepute to the University.

6. I also declare that I am not suffering from any serious /contagious ailment and/or any
psychiatric/physiological disorder.

7. I agree to absolve and not hold responsible for, Alliance University, as well as its managers, trainers,
instructors, administration officers, coaches, or any other person associated with Alliance University for any
losses, injuries, mishaps, medical issues, and/or any other consequences of my decision to participate in the
event, as per details mentioned above. I understand that no financial and/or legal claims can be made against
Alliance University.

8. I hereby declare that I shall be solely responsible for my involvement in any kind of undesirable/in disciplinary
activities during the event and shall be liable for punishment as per the law of the land. I further understand
that the Institution/University shall in no way provide any support to me and will not be held responsible for
any such action. I, further declare that my participation in the event may be canceled/revoked at any stage, if I
am found violating the above declaration or if I am found ineligible and or the information provided by me is
found to be incorrect.

Signature of Student:
Name of Student:
Mobile Number:
Date:

Verified by: Permitted by: Approved by:

Date: Date:
Date: