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POST SCHOOL ACTIVITY - ENROLMENT FORM (For Existing Students)

School Location: Date:

A) Student’s Information (Please fill in BLOCK CAPITAL LETTERS ONLY)

Full Name:
(as per Birth/Leaving Certificate)

Enrolment No.: Grade:

Emergency Contact No.:

Medical Concerns / Allergies (If any):

B) Activity Details
Sr.No. Name of the Activity Batch Timings

C) Transport Details

Are you already availing Transport facility: Yes No

Would you like to avail Transport Facility?: Yes No

If yes, please mention drop off location:

Note: A minimum of 10 to 15 students (per bus per route) required for transport facility.
Incase of lack of registrations, transport facility for that route will not be available.

D) Declaration by Parents / Guardians

1) I / We have carefully and thoroughly read and a er having clearly understood the terms, condi ons, covenants,
rules, regula ons, policies, guidelines, disciplines, declara ons and undertakings pertaining to PSA to be
followed at the School stated herein below as also those s pulated on the School's website, if any, which have
also been thoroughly and duly explained to me / us. I / We do hereby voluntarily and willfully without any kind
of force, pressure, coercion or undue influence of any nature or to any extent under any circumstance
whatsoever from the management of the School or any other authority or person or en ty assure, declare,
confirm, agree, acknowledge, state and undertake that these are acceptable to me / us including any

VB/MKT:FRM/PSAE/02 18.02.2019
 subs tu ons for or modifica ons , amendments to them, which may be made by the School authori es from
me to me at their sole, exclusive and absolute discre on and we uncondi onally and unequivocally assure,
confirm, agree, acknowledge and undertake to comply with and abide by the same at all mes..
2) I / We fully understand and acknowledge that the selec on and / or acceptance and / or removal of my /our
child in PSA would be at the sole, exclusive and absolute discre on of the School and / or its management and I /
we shall not raise any objec on in respect thereof.
3) I / We fully understand and acknowledge that in case my / child has a medical history or has chronic ailments,
the child will not be permi ed to join the ac vity for precau onary reasons.
4) I / We fully understand and acknowledge that the payments are to be made at the fee counter. The cheque
should be in favour of “VIBGYOR SPORTS & EVENTS”.
5) I / We fully understand and acknowledge that the payment/s once made will not be refunded;
unless the ac vity is cancelled by the school. In the event of refund, cheque to be made in favour of
“____________________________”
6) I / We declare and confirm that I / we shall abide by the direc ons of the School and with the prescribed safety,
security and precau onary measures at all mes during the course of training of the children / students.
7) I / We fully understand and acknowledge that the School will do its best to provide all safety and security
measures, first aid and take all precau ons possible. In case of any unavoidable mishap, accident, unfortunate
or untoward incident or accident or injury of any nature, under any circumstance whatsoever to my / our child
including while par cipa ng in any ac vi es, events, despite best efforts of the School, I / we shall not hold the
School and/or other en es in the VIBGYOR Group and/or its parent body and/or its management and/or its
members, staff, officials, employees, agents, coaches, trainers and/or its Principal, Vice Principal, Teachers,
trustees, successors, representa ves, affiliates, administrators, assigns liable and/or responsible and/or
accountable for it in any manner or to any extent and under any circumstances whatsoever and no
compensa on of any nature and to any extent in respect thereof will be payable by the School and/or its
management.
8) I / We fully understand and acknowledge that transport facility, if available, shall be provided for PSA on my /
our request and on payment of the requisite charges, if any, and on the applicable terms and condi ons. I / We
understand and acknowledge that the 'Transport Facility' is a privilege and not a right for any person desiring to
avail the facility. The School retains the sole, absolute and exclusive right to deny the facility to anyone, at its
discre on, without assigning any reason whatsoever.
Name:

Relationship with student: Mother Father Guardian

Signature

E) For office use only

Receipt No.:

Mode of Payment: Card Cash Online Cheque (in favour of VIBGYOR SPORTS & EVENTS)

Rupees: Bank Name:

Cheque No.: Card Transaction No.:

Signature and Date:

Relationship Officer: Accounts Department:
Transport Coordinator: SPA Coordinator:
Principal:

VB/MKT:FRM/PSAE/02 18.02.2019