Health Declaration
Please complete this form to let us know the health of your child and your household.
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Students's Name *
Parent/Guardian Name *
Email *
Emergency phone number - in case of illness *
I agree that if my child or any member of my household is unwell with any of the coronavirus symptoms, the child will be kept at home and will not be brought to the dance school. *
Required
I agree to give verbal confirmation that my child and other members of my household are free of coronavirus symptoms when I bring my child to the dance school. Students 12 and over may give the confirmation. *
Required
I agree that if my child or other member of my household has been instructed to self isolate, that my child will not be brought to the dance school until the end of the isolation period. *
Required
Date *
MM
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YYYY
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