West Coast Swing Class - Gift Certificate Check-in
Please complete this form prior to attending each weekly West Coast Swing class.
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Email *
Name: *
Cell Phone: *
From whom did you receive your gift certificate? *
Which date are you attending? *
In the 2 weeks before your class date, have you traveled outside Connecticut or New York? *
In the 2 weeks before your class date, have you attended an event that included all of the following:

a) was indoors
b) 100 or more attendees
c) unvaccinated attendees, and
d) dancing or dining

(Examples: a dance event, cruise ship, wedding, bar/bat mitzvah, holiday party, etc.)
*
In the 2 weeks before your class date, have you tested positive for COVID-19 or been in close contact with someone who has COVID-19? *
If you answered "Yes" to any of the above questions, please provide details below, take a home-COVID test, and email a picture of the result to Erik@SwingShoes.net:
A copy of your responses will be emailed to the address you provided.
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