RDT's Dance Center on Broadway Waiver 2020

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In order to prevent the spread of COVID-19 and keep RDT's Dancer Center employees and students safe, each participant is required to fill out this waiver right before attending any class. If you have any questions, please contact us at 801-534-1000 or rdt@rdtutah.org

Name *

Email *

Date *

YYYY

Emergency Contact Name and Number *

If you have any of the following symptoms, you should not be attending class:

Cough
Shortness of breath or difficulty breathing
Fever
Chills
Repeated shaking with chills
Muscle pain
Sore throat
New loss of taste or smell

Please verify that you do not have any of the symptoms listed above. *

I do NOT have symptom(s)

I DO have symptom(s)

Required

Release Policy

I, the undersigned, hereby represent that I am of legal age, or that I am the guardian of the student named below, and hereby release and forever discharge the Repertory Dance Theatre (RDT) and all members of said organizations and all agents, representatives and employees of said organizations and their successors from all claims and demands which I , my heirs, executors and administrators, have or may have against said organizations by reason of participation in classes conducted by RDT, and hereby assume all risks in such activity.

Please check the box to acknowledge you have read and agree to abide by the above Release Policy *

I have read the Release Policy and commit to following it.

Required

Please type your name below to sign the RDT's Dance Center on Broadway waiver form. *

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