To,

The Director,

Institute for Technology & Management

Indemnity BondWe the Student of ITM (Institute for Technology & Management (List as per the annexsure - A) are aware that travel, whether in civilized or remote area or by any mode like Bus, Jeep, Auto, Train or Raft entails an inherent risk factor such as illness, injury or death which may be caused by negligence of others/self, forces of nature or other known or unknown factors.

We recognize that such risks may be present at any time before, during and after any trip that we participate under arrangement of Institute for Technology & Management and its associates or agencies.

We are also aware that medical services/facilities may not be readily available or accessible during some or all the time we are participating in any Institute for Technology & Management or trip.

We hereby fully assume all risk of illness, injury, death and hereby release and discharge Institute for Technology & Management and or its agents and associates from all actions, claims or demands for damages resulting from my participation in the trip.

We hereby indemnify and agree that foregoing obligation shall be binding upon me personally as well as upon my heirs, executors and administrators, all members of my family including any minor accompanying me. We have carefully read this agreement and fully understand its contents and hence am signing it of my own free will. We also note that we will not try any activity without the supervision of instructors.

The bus will be travelling from ITM Campus Kharghar to IES Management Institute Hall, Opp. Lilavati Hospital, Bandra Reclamation, Bandra (W), Mumbai-400 050. on 29th Novembar 2013.

Name of student / Signature:

Place :

Date :