Sign up form for Covid-19 Testing
If you are a parent or guardian, please enter information for your child or dependent first and later in the form please provide the information for parents or guardians as the portal user(s). If you are and adult filling out the form for yourself please enter your information for participant and for portal user. If you have multiple children or dependents to enter, please follow the link at the end of this form to complete additional forms.
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Thank you for participating in our voluntary testing program.
Your test results will not be made available to anyone at Grandstreet Theatre so we rely on you to contact Grandstreet as soon as possible if you receive a positive test result.
Participant First Name *
Participant Middle Name
Participant Last Name *
Participant Role *
Date of Birth *
(MM/DD/YYYY)
MM
/
DD
/
YYYY
Sex (Male, Female, Unknown/Other) *
Race
Ethnicity
Street Address (123 Main St) *
City *
State *
Zip Code *
County *
Phone Number    123-456-7890 *
Please provide a 10 digit phone number
Primary Portal User First Name *
Primary Portal User Last Name *
Primary Portal User Email Address *
Secondary Portal User First Name
Secondary Portal User Last Name
Secondary Portal User Email Address
Weekly testing will be conducted at 3:30pm and available M-TH at Grandstreet Theatre's upper studio located directly behind the theatre.
Please indicate your preferred testing day. Theatre School Students should select the day they attend theatre school.
Preferred Testing Day *
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