consent form 9-12

1. CONSENT FORM
Dear Sir/Madam,
I , …………………………….F/o, M/o ………………………………. , studying in …………class ……….Sec……… , extend
permission/consent to send my above named ward to attend the school as per the circular of the
State Government and my ward will follow the various precautions related to Pandemic Corona and
SOP as issued by the Ministry of Health and Family Welfare, MHRD/MHA.
I assure that apart from the precautionary arrangements made by the school, my ward shall also
follow the safety precautions.
My ward will use Face mask, carry alcohol based hand sanitizer in pocket/bag, carry own water
bottle & lunch box, will not share any eatables or stationery items and maintain social distance.
He/ She will not attend school in case of sickness/ill health and immediately inform the class
teacher about the sickness (Covid infection) of any family member in the house. He / She will
occupy only the allocated seat in class by the teachers, will always follow rules and regulations/
instructions of the school staff from time to time.
· Given the unknown nature of COVID-19, it is not possible to fully list each and every
individual risk of contacting COVID-19. Hence, I shall not hold the school responsible in case
my child gets infected by it in future.
· While attending school, my child will abide by the COVID-19 guidelines, will maintain social
distancing in the school and will not create any indiscipline. The school will be permitted to
take appropriate action if found so.
I shall be careful and will ensure that my ward follows all the precautionary measures and I will send
my ward as per the Roster shared by the class teacher.
PARENT’S NAME & SIGNATURE :
STUDENT’S NAME :
ADDRESS :
MOBILE NUMBER :
DATE :