How to fill Sainik School Kodagu INDEMNITY CERTIFICATE Appendix-L ( See Example )

Appendix-L

INDEMNITY CERTIFICATE

In consideration of my son/ward Roll No. ...................Name AMIT KUMAR KUSHWAHA being allowed at his/my request to swim in the Sainik School Kodagu Swimming Pool, to participate in shooting and horse riding and all training activities to include sports and games, I undertake and agree that neither I nor my executor nor administrator will make any claim against the Government of India or against any Officer, Instructor or any person in the service of Sainik School Kodagu or the Sainik Schools Society in respect of any loss or injury including the death which he may suffer during the above training including any new training introduced during the year/swimming/horse riding and I understand that no compensation will be paid by the Government of India for any loss or injury including death and I agree so as to bind myself, executors and administrators to indemnify the Government of India or any Officer/Instructor of Sainik School, Kodagu against any claim.

________________________

(Signature of Parent/Guardian)

Address: Vill-              Po-

Dist-            ( Bihar )

Signed by Parent / Guardian in my presence

WITNESS:

(1)          ____________________________

(Signature)                                               Name : Manoj Kushwaha

          Date :_______________________                    

Address: Vill-                  PO-

Dist –                        (Bihar)

(2)          ____________________________

(Signature)                                                  Name : Pramod Kumar

Address:Vill-                 PO-

Dist-                             (Bihar )

Date :_______________________