ID Card / Escort Card Form
Name of the Scholar
Grade
Affix scholar’s Admission Number
photo here
Facility opted for
Day Extended Day
5 Day Residential 7 Day Residential
(The below mentioned people are authorised to escort the scholar to & from the Bus stop/School)
Name Name Name Name
Relation Relation Relation Relation
Date
Parents’ Signature
Parents’ Name
For Office Use Only
Date of receiving the form
Received by
Medical History Form
Name of the Scholar Important
We request you to be completely thorough in providing
information requested below, to Genesis Global School.
Grade
Many scholars over the years have had a variety of
medical and psychological difficulties which have not,
Admission Number in any way, interfered with their success at Genesis Global
School; however, for the scholar’s own safety and health,
the medical staff must be aware of such problems.
Weight
Please check every condition that applies to your ward
Height and provide detailed comments, including date of the
condition, medication and current status of the condition.
Use additional pages or support the document with
Blood Group
medical reports, if necessary.
Has your ward ever suffered from?
1. Asthma / Wheezing No Yes
If yes, please give details
2. Bleeding Disorder No Yes
If yes, please give details
3. Diabetes No Yes
If yes, please give details
4. Epilepsy / Convulsions No Yes
If yes, please give details
5. Blood Pressure No Yes
If yes, please give details
6. Migraine / Headache No Yes
If yes, please give details
7. Syncope / Fainting No Yes
If yes, please give details
8. Heart Problem No Yes
If yes, please give details
9. Eye Problem No Yes
If yes, please give details
Medical History Form
10. Hearing Problem No Yes
If yes, please give details
11. Ankle / Knee / Joint Problem No Yes
If yes, please give details
12. Frequent infections of
a. Ear No Yes
If yes, please give details
b. Throat / Tonsils No Yes
If yes, please give details
c. Sinuses No Yes
If yes, please give details
13. Does your child have any special / restricted Dietary Needs? No Yes
(Please attach a photocopy of the Diet Chart)
If yes, please give details
14. Has your ward been hospitalized within last 3 years? No Yes
If yes, please give details
15. Has your ward suffered from Typhoid / Jaundice in last 3 years? No Yes
If yes, please give details
16. Has your ward been exposed to Tuberculosis in last 3 years? No Yes
If yes, please give details
17. Is your child allergic to:
a. Bee sting / Insect Bite No Yes
If yes, please give details
b. Any Medicine No Yes
If yes, please give details
c. Food Item No Yes
If yes, please give details
18. Is your ward taking any medication? No Yes
If yes, please give details
Medical History Form
19. Can the following medications can be given to your ward, in case of an emergency:
a. Paracetamol / Crocin No Yes
If yes, please give details
b. Anti- Histamine / Anti-Allergic No Yes
If yes, please give details
c. Antacids / Digene No Yes
If yes, please give details
d. Non-steroidal anti-inflammatory No Yes
If yes, please give details
e. Any injections (only in case of an emergency) No Yes
If yes, please give details
20. Does your ward require Glasses or Contact lenses? No Yes
If yes, please give details
21. Has your ward been immunised as per the schedule? No Yes
(Please attach a photocopy of the Immunisation Card)
22. Is your ward taking any medications? No Yes
(Please attach a photocopy of the Doctor’s prescription)
Note
Any medication carried by a day scholar or scholar in residence must be handed over to the class mentor or House Parent, respectively. Medication will be
administered by the School Nurse, as per prescription provided by Parents’.
Medical Certificate
This is to certify that I Doctors’ Signature
(Name & Stamp with [Link].)
have examined
of Grade Age Date
Note
and found that he/she is not suffering from any This certificate has to be signed by Regd. MBBS Doctor.
chronic/contagious disease or any disability which
prevents him/her from attending the swimming classes.
For Office Use Only
Date of receiving the form
Received by
Swimming Consent Form
Name of the Scholar
Grade
Affix scholar’s Admission Number
photo here
Facility opted for
Day Extended Day
5 Day Residential 7 Day Residential
I/We, Mr. / Mrs. Parent/Parents’ of
studying in Grade of Genesis Global School, Noida, do hereby give my willing consent for my ward to use the
school’s swimming pool. I will not hold the School responsible for any accident that may inadvertently occur during the
course of such use and swimming activity.
Date
Note
Parents’ Signature You can rest assured that the school will take all safety precautions while conducting
swimming classes, including the presence of a qualified swimming coach, lifeguard,
security guard and inflated tubes. Swimming activity will be properly supervised.
However, swimming can only be permitted on receipt of the signed Consent Form,
Parents’ Name
with an attested Medical Certificate, enclosed herein.
Medical Certificate
This is to certify that I Doctors’ Signature
(Name & Stamp with [Link].)
have examined
of Grade Age Date
Note
and found that he/she is not suffering from any This certificate has to be signed by Regd. MBBS Doctor.
chronic/contagious disease or any disability which
prevents him/her from attending the swimming classes.
For Office Use Only
Date of receiving the form
Received by
School Transport
& Declaration Form
Name of the Scholar
Grade
Affix scholar’s Admission Number
photo here
Facility opted for
Day Extended Day
5 Day Residential 7 Day Residential
Subsequent to my wards admission to Genesis Global School, I
request the School, that my child of Grade
may please be allowed to avail the transport facility being provided by the school at the set rates.
Although, I understand that the school will provide full security and safety, exercising due diligence in carrying out the
service, the school shall not be held responsible in case of any mishap. I also understand that the school reserves the
right to alter/modify/restructure any route, at any point of time in the interest of children and school, as well.
I agree to abide by all the rules and regulations laid down by the School Authorities.
Name of Parent
Address Telephone Nos.
Date
Parents’ Signature
For Office Use Only
Route No. (Pick-Up)
Bus Fee Paid No Yes
Route No. (Drop) Facility paid for
Day Extended Day
5 Day Residential 7 Day Residential
Transport Department Signature Account’s Department Signature
Choice of Facility Form
Name of the Scholar
Grade
Affix scholar’s Admission Number
photo here
Facility opted for
Day Extended Day
5 Day Residential 7 Day Residential
Extended Day Transport
Till 3:15pm Till 5:45pm Yes No
Date
Parents’ Signature
For Office Use Only
Fee Paid for Transport
Yes No
Facility paid for
Day Extended Day Account’s Department Signature
5 Day Residential 7 Day Residential
Notes
[Link] Facility Class Remarks
1 Day Pre–Nur School Hours–9:00am to 12:15pm (if not using transport)
Pre–Nur–KG School Hours–7:45am to 12:15pm
Grade 1–12 School Hours–7:45am to 3:15pm
2 Extended Day Pre–Nur School Hours–7:45am to 3:15pm
Nursery to KG School Hours–7:45am to 3:15pm / 5:45pm
Grade 1–12 School Hours–7:45am to 5:45pm
3 5 Day Residential Grade 1 onwards Scholars stays in School from Monday to Friday
Weekend at home
4 7 Day Residential Grade 1 onwards Scholars stays in School through the entire week
Change of Facility Form
Name of the Scholar Admission Number
Grade
Facility opted for
Extended Day
Day Extended Day
5 Day Residential 7 Day Residential Till 3:15pm Till 5:45pm
Transport
Yes No
Address (if yes) Telephone Nos.
Date
Parents’ Signature
For Office Use Only
Fee Paid for Transport Facility paid for
Yes No Day Extended Day
5 Day Residential 7 Day Residential
Account’s Department Signature
Notes
[Link] Facility Class Remarks
1 Day Pre–Nur School Hours–9:00am to 12:15pm (if not using transport)
Pre–Nur–KG School Hours–7:45am to 12:15pm
Grade 1–12 School Hours–7:45am to 3:15pm
2 Extended Day Pre–Nur School Hours–7:45am to 3:15pm
Nursery to KG School Hours–7:45am to 3:15pm / 5:45pm
Grade 1–12 School Hours–7:45am to 5:45pm
3 5 Day Residential Grade 1 onwards Scholars stays in School from Monday to Friday
Weekend at home
4 7 Day Residential Grade 1 onwards Scholars stays in School through the entire week
Guardian Information Form
Guardian’s Name
Address
Affix scholar
photo here
Home Phone Number
Business Phone Number
Mobile Phone Number
E-Mail ID
Mr. & Mrs. parent’s of
who is in grade has authorised me to be the local guardian for the academic year to
I/We will be responsible for any enquiry, special permissions, any field trips and medical welfare of the scholar as well as
the safety and development of
I/We will also undertake responsibility to accommodate him/her in case of any suspension from Boarding.
Guardian’s Name Parents’ Name
Signature Signature
Date Date
Please attach proof of ID i.e, relevant passport page or driving licence, and valid Indian visa and residence permit.
For Office Use Only
Date of receiving the form
Received by
EMERGENCY CONTACT NUMBERS
Name Designation Mobile
RECEPTION 9711000498/560/625
MANAGEMENT
Neeti Bhalla Head Junior School (Pre-Nursery – 5) 9711000835
Seema Hanvey Head Intl. Certification (Grade 6-12) 9711577701
Ajay Singh Head CBSE (Grade 9-12) 9711577709
Pradeep Paul Head Residences 9953574689
Aradhana Kaul Head Middle School- CBSE (Grade 6-8) 8860737777
Alka Sarkar Head Pre- Primary School (Pre-Nursery to KG) 9953137564
Ramesh Kumar Sports Coordinator 9999072537
ADMISSIONS
Deepika Gupta Admission Counsellor 8860632703
TRANSPORT/ SECURITY
Amit Rana Manager 9711577706
HOSTEL
Pradeep Paul Head Residences 9953574689
Ankur Bhatt House Parent- Boys 9711000548
Jaganath Banerjee House Parent- Boys 9990627505
Sunita Bansal House Parent- Girls 9711000546
Vanita House Parent- Girls 9953184542
SICK BAY
Dr. Anuradha Doctor 9711000742
ACCOUNTS
Prakash Bhatt Manager 9711000497
THINGS TO BE BROUGHT FROM HOME
Kindly have these items checked by the House Parent on arrival(for new students) and signature
taken
STUDENT'S NAME: CLASS:
QTY PLEASE
[Link] DESCRIPTION
TICK
GIRL BOY
LUGGAGE
1 AIR BAG (size: 24" x 12" x 12") 1 1
2 SUITCASE (size: 29'' x 18'' x 9'') 1 1
3 LOCK(KEY LOCK) & CHAIN 1 1
FOOTWEAR
4 SPORTS SHOE 1 1
5 BATHROOM RUBBER SLIPPERS 1 1
CLOTHING
6 HANDKERCHIEFS (COTTON- WHITE) 12 6
7 NIGHT SUITS(UPPER + LOWER) 2 2
8 CASUAL SOCKS (COTTON) 4 4
9 VESTS & DRAWERS (COTTON) 10 6
10 DRESSING GOWN 1 1
11 BASEBALL CAP 1 1
12 SWIMMING COSTUME (WITH CAP AND SPECS) 1 1
OTHER ITEMS
13 BATH TOWELS (SIZE: MAX. 140CM) 2 2
14 COMB 1 1
15 HAIR BRUSH 1 0
16 HAND TOWELS 3 3
17 PLAIN NAIL CUTTER* 1 1
18 PENCIL BOX 1 1
19 SHOE BRUSH 1 1
20 KIWI LIQUID POLISH (BLACK) 1 1
21 HANGERS 8 8
TOILETRIES (as required)
22 TOOTH BRUSH 3 3
23 TOOTH PASTE 2 2
24 TONGUE CLEANER 2 2
25 SHAVING KIT (OPTIONAL) (GRADE XI ONWARDS)
26 BATHING SOAP/ SHOWER GEL 2 2
27 SOAP DISH (IF USING BAR SOAP) 1 1
28 SHAMPOO (LARGE) 1 1
29 FACE WASH (OPTIONAL) 2 0
30 HAIR DRYER (OPTIONAL) 1 1**
31 DETERGENT BAR FOR UNDERGARMENTS*** 3 3
32 COLD CREAM 1 1
1
33 FACE CREAM or SUNSCREEN LOTION 1 1
34 OIL (BODY & HAIR) 1 1
TALCUM POWDER (DERMICOOL/ NYCIL) OR
35 1 1
DEODORANT****
36 BODY LOTION (MOISTURISER) 1 1
37 PETROLEUM JELLY 1 1
38 LIP BALM 1 1
HOME CLOTHES (For Summers)
39 BLUE JEANS OR SKIRT 2 2
40 TRACK SUIT (Summer) 1 1
41 HALF SLEEVED T-SHIRT***** 3 3
HOME CLOTHES (For Winters)
42 PULLOVER****** 2 2
43 WARM INNER SET 2 2
44 FULL SLEEVES SWEATER/ SWEAT SHIRT 2 2
45 HALF SLEEVED SWEATER/ SWEAT SHIRT 2 2
46 WARM SOCKS 4 4
47 WARM CAP 1 1
* WITHOUT KNIFE, OPENER AND NAIL FILLER
** BOYS BELONGING TO SIKH COMMUNITY ONLY
*** CLASS VII ONWARDS
**** NON SPRAY- ONLY SPLASH
***** SHOULD NOT CARRY ANY SLOGAN OR LOGO, OFFENSIVE IN NATURE
FULL SLEEVED, SHOULD NOT CARRY ANY SLOGAN OR LOGO, OFFENSIVE IN
****** NATURE
_________________
(Signature- House Parent)
Important Notes for Parents:-
a) All the articles brought by the student should be marked with his/her name.
b) All the clothes brought by the student, needs to be labelled with the students 1st name and the Admission number.
Also, all 7 day boarders need to carry 40 extra labels with them.
c) All 7 day boarders need to buy 4 sets of the School uniform.
d) Student needs to carry 20 passport size photograph of himself/herself.
e) Electronic Music Equipment like an MP3 player may be used in the hostel rooms on Sundays, Holidays and during
the daily rest hours only. It must not be taken to Class at any time.
f) Toxic items, possession of smoking and drinking materials or any eatables, fireworks, darts, cutters or any other
sharp objects are strictly forbidden.
g) Other than a simple watch (for boys and girls) & jewellery (bali’s for girls only), no student is allowed to carry any
other valuable material. The school holds no responsibility whatsoever for the loss of any of the above.
h) Any medication carried by a student must be handed over to the House Parent directly. Medication will be
administered by the School Nurse, as per prescription provided by Parents.
i) Parents are required to read the above carefully as these are enforced strictly. No exceptions will be made.
