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Undertaking by the Parent/Guardian

I ___________________________________________________________________, the parent / guardian of


__________________________________________________________. My ward has been selected by IIT
Goa (nodal institute for the program Yuva Sangam Ek Bharat Shrestha Bharat) as a
delegate from Goa to IIT Mandi (Himachal Pradesh) scheduled from 15th - 25th May
2023, for a duration of 10 days. They will depart from Goa on 15th May, 2023 at 3.45pm
from Margao and arrive in Goa on 25th May, 2023 at 5.40am.
I understand that the Goa College of Engineering cannot be held responsible for any
unforeseen circumstances or situations beyond control, such as accidents, injuries,
illnesses, or acts of nature, during the trip. I also confirm that my ward is in good health
and has no medical conditions that could affect their participation in the trip.
Thank you for permitting my ward, and I look forward to their enriching experience at
the program.

Date:
Place:

_________________________ _________________________
(Parents/Guardian’s Signature) (Student’s Signature)

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