Indemnification Undertaking by Student - 3

LETTER OF UNDERTAKING / AUTHORISATION
I, , father/ guardian of:

student of
, [a constituent of Symbiosis
International University do hereby declare and undertake as follows:
1. My son / daughter / ward is pursuing at .
2. I understand and agree that University and / or Institution and/or its

Authorized Representatives have no control on activities, which my son /
daughter / ward decide to engage him / herself voluntarily. He / She should
not engage himself / herself in activities which may cause injury to his / her
person or property.
3. In case, any injury is caused to person / property of my son / daughter / ward

due to his / her involvement / engagement in any manner in any activity, which
is not authorized by University and / or Institution or on which University and /
or Institution does not have any direct / indirect control, which may or may not
be during the course of performing authorized activities like participation in
sports events,presentation,study excursion tour, presentation out bound
program,etc then in such case entire responsibility rests upon my son /
daughter / ward and I undertake that I shall not held University and / or
Institution responsible for causation of such injury.
4. I have been given to understand by my son / daughter / ward that Symbiosis

also promotes sports, because it believes in the principle of “sound mind in sound
body”. The participation in regular sports features or tournaments is completely
voluntary.
5. I am well aware that any sports event has some inherent risks involved in it. I am
also aware while playing some sports some accidents may be caused. However,
since my son / daughter / ward participation to regular sports features of the
Institute / University or any specific tournament is completely voluntary, I shall
not make any claim any amount as compensation or otherwise due to any injury
caused to person or property arising out of voluntary participation of my son /
daughter / ward.
6. I also understand that in case any injury is caused to my son / daughter /

ward, certain medical procedure need to be performed by hospitals or other
specialised health care centres, to address the medical problem. In certain
cases, consent is required to perform the required medical procedures. I also
understand that any delay in producing the consent may prove to be fatal for
my child and under any circumstance, medical treatment should not be delayed
for want of my consent.
7. I therefore in interest of my child authorize the Symbiosis International

University and /or the Institution and/or any person designated University and/or
Institution, to give consent for me and on my behalf to perform the medical
procedures on my son/ daughter/ ward.
8. I shall stand by this authorization and shall not hold Symbiosis International
University and /or the Institution and/or any person designated by the
University / Institution responsible / liable for giving consent.
9. Symbiosis has insured my son /daughter/ ward to meet the medical expenses to
Rs. 50,000/in case of non accidental emergencies (as per the Mediclaim
Insurance Policy)& Rs.1,00,000/- in case of Rail/Road Traffic accidents. But it
may happen that in all cases the insurance policy may not be honored hence the
University/Institution may have to incur the expenses. I undertake to pay the total
amount with in 15 days of demand by the Institute.
10. I have signed this Undertaking and authorized Symbiosis International University and
/or the Institution and/or any person designated by University and/or Institution
to give consent for medical procedure to be performed on my son / daughter /
ward on my free will and without any influence / pressure from any person.
Hence this Undertaking and Authorization.
Place:
Date:
Signature of the Parent

LETTER OF UNDERTAKING
I, ,Age: Yrs., student of

, [a
constituent of Symbiosis International University, do hereby declare and undertake
as follows:
1. I am pursuing with . At the time of

admission, the Institution had arranged for a detailed Induction Programme.
2. During the admission process, I have been explained the disciplinary rules of
the Institution and I have understood the same. I was also made aware of the
Code of Conduct, Academic Rules, Examination Rules, Dress Code, Library
Policy of the Institute and I have understood the same.
3. As a student I understand and agree that I have joined this University for
academic pursuits and for holistic development of my personality. I agree that
University and / or Institution and/or its Authorized Representatives have no
control on activities, which are not related to course curriculum and in which I
decide to engage myself voluntarily. It also sometimes happens that during the
course of performing authorized activities, students engage in activities on
which there is no direct / indirect control of the authorities of the University /
Institution.
4. I also understand that as a responsible student of the University I should not

engage myself in activities which may cause injury to my person or property. In
case, any injury is caused to my person / property due to my involvement /
engagement in any manner in any activity, which is not authorized by the
University and / or Institution or on which University and / or Institution does not
have any direct / indirect control, which may or may not be during the course of
performing authorized activities like participation in sports events, presentation,
study excursion tour, presentation, out bound program, etc., then I am the
person solely liable to bear its consequences. I undertake that I shall not hold
the University / Institution liable in any manner whatsoever for the same.
5. Symbiosis also promotes sports, because it believes in the principle of “sound

mind in sound body”. The participation in regular sports features or
tournaments is completely voluntary.
6. I am well aware that any sports event has some inherent risks involved in it. I am
also aware while playing some sports some accidents may be caused. However,
since my participation to regular sports features of the Institute / University or
any specific tournament is completely voluntary, I shall not make any claim
any amount as compensation or otherwise due to any injury caused to person
or property arising out of my voluntary participation.
7. During the process of induction / admission process the students were also
informed that that Symbiosis Centre of Health Care (SCHC) has establishment on
the Campus where the students can avail First Aid Facility. I therefore
understand that SCHC is responsible only for primary medical assistance and
any higher degree of medical care or any medical emergency will be addressed
by referral to specialized centers.
8. I also understand that in case of a medical problem, certain medical procedures
may need to be performed by hospitals to treat the Medical conditions. In such
cases, as decided by the doctor, consent is required to perform the required
medical procedures. Any delay in producing the consent may prove to be fatal and
under any circumstance, medical treatment should not be delayed for want of
consent from my parents/ guardian.
9. I therefore, in my interest, authorize the Symbiosis International University and

/or the Institution and/or any person designated by the University /Institution, to
give consent for me and on behalf to perform the medical procedures. I shall
stand by this authorization and shall not hold Symbiosis International University
and /or the Institution and/or any person designated by the University /
Institution responsible / liable for giving consent.
10. Symbiosis has insured each student to meet medical expenses up-to Rs. 50,000/-
in case of non accidental emergencies (as per the Mediclaim Insurance Policy)
& Rs.1,00,000/- in case of Rail/Road Traffic accidents. But it may happen that in
some cases (exclusion clauses), the insurance policy may not be honored.
Hence the University/Institution may have to incur certain expenses. I and/or
my parents undertake to pay the total amount within 15 days of demand by
the University / Institute.
11. I have signed this Undertaking and authorized Symbiosis International University and
/or the Institution and/or any person designated by University /Institution to
give consent for medial procedure on my free will and without any influence /
pressure from any person.
Hence this Undertaking and
Authorization. Place: Pune
Date:
Signature of the Student

Indemnification Undertaking by Student - 3

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LETTER OF UNDERTAKING / AUTHORISATION

I, , father/ guardian of:

1. My son / daughter / ward is pursuing at .

2. I understand and agree that University and / or Institution and/or its

3. In case, any injury is caused to person / property of my son / daughter / ward

4. I have been given to understand by my son / daughter / ward that Symbiosis

6. I also understand that in case any injury is caused to my son / daughter /

7. I therefore in interest of my child authorize the Symbiosis International

Hence this Undertaking and Authorization.

Signature of the Parent

I, ,Age: Yrs., student of

1. I am pursuing with . At the time of

4. I also understand that as a responsible student of the University I should not

5. Symbiosis also promotes sports, because it believes in the principle of “sound

9. I therefore, in my interest, authorize the Symbiosis International University and

Hence this Undertaking and

Authorization. Place: Pune

Signature of the Student

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