NJADS Student/Guest Pre-Screening Form Winter 2021
Please complete ALL of the following questions prior to visiting our studio for dance.  Students not completing this questionnaire WILL NOT be allowed into the studio for class.  The form only needs to be completed in once.  Parents are then required to self-screen their child EVERY TIME that they visit the studio.  If they have ANY of the symptoms of COVID-19, please do not attend class, and seek appropriate medical attention.  If any person in your household is awaiting COVID-19 test results, dancers MAY NOT attend class until a negative result is received.  Advise the studio of any COVID testing done on your child and the results.  See our full COVID-19 Policies and Procedures online in our Studio Portal or your Parent & Student Handbook.

**** PER HAMILTON BY-LAW 20-155 ALL STUDENTS, STAFF AND VISITORS TO OUR STUDIO MUST WEAR A FACE MASK WHEN COMING INTO OUR STUDIO *****

YOU WILL BE DENIED ENTRY INTO THE STUDIO IF YOU DO NOT HAVE A FACE MASK...please bring a face mask with you that properly fits, and covers your child's nose and mouth.   If you do not have a face mask we have disposable masks available for $2 + HST.

Thank you for your continued patience and understanding.  Our number 1 priority is to ensure the health and safety of our dancers, our staff and the community in general.
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Student's First and Last Name *
Does your child have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions.  Fever or chills, Difficulty breathing or Shortness of breath, Cough, Sore throat, Difficulty swallowing, Runny nose/stuffy nose or nasal congestion, Decrease or loss of taste or smell, Nausea/vomiting, diarrhea, abdominal pain, Not feeling well, extreme tiredness, sore muscles *
Has your child or your family travelled outside of Canada in the past 14 days?   *
Has your child or family had close contact with a confirmed or probable case of COVID-19? *
Is your child, or any member of your family awaiting COVID-19 test results? *
Is your child willing to wear a mask when attending classes at the studio, having their temperature taken before entering the studio and wash/sanitize their hands before and after class to protect against the possible spread of COVID-19? *
Do you agree to notify NJADS INC. immediately if you or someone you are in close contact with are diagnosed with, or develop symptoms of COVID-19? (So that contact tracing may be done, and to ensure the safety of our other students during that time period.) *
Do you agree to self-monitor your child for any symptoms of COVID-19 each time that your child visits the studio, and to stay home from class if they have a fever, vomiting, diarrhea or other symptoms of COVID-19 such as dry cough, shortness of breath or tiredness? *
Students and instructors will be socially distanced by 6 feet or more during class.  I hereby authorize NJADS Instructors to enter this social distancing barrier to make corrections to my child during dance class. (i.e. contact to correct to posture, position, technique or to spot during acro class).  Both student and instructor must wear their mask if within 6 feet, and hand sanitizer must be used before and after contact has been made.  NOTE: if we are in the RED ZONE, contact will not occur. *
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