DCC In-Studio Instruction Consent Form

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Please complete the following form after reviewing DCC's guidelines for attending classes with in-person instruction at the studio during the ongoing COVID-19 pandemic. No student will be permitted to take in-person classes at the studio without submitting this form.

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E-mail *

Emergency contact number: *

Dancer(s) Name *

I have thoroughly read and reviewed the DCC guidelines for in-person instruction at the studio during the ongoing COVID-19 pandemic with my child and household. *

Yes

I knowingly and willingly consent for my child to attend in-person instruction at Dance Conservatory of Charleston during the ongoing COVID-19 pandemic. *

Yes

Have your child or anyone in your household currently experiencing or have experienced any of the following symptoms in the last 14 days: Cough, shortness of breath or difficulty breathing, fever, chills, muscle pain not related to injury, sore throat, new loss of taste of smell, nausea, vomiting or diarrhea? *

No one in my household, including my child, have experienced any of these symptoms in the past 14 days.

Yes

If yes, please consult your doctor before attending any in-person classes at the DCC studio.

I understand that traveling within or outside the United States presents a greater risk of contracting or transmitting COVID-19. I verify I have not traveled within or outside the United States by airline, bus, or train in the past 14 days. *

Yes

I understand that my child and household will have to follow DCC's strict guidelines to attend in-person classes. *

Yes

Please type your full name as your electronic signature. By signing, I confirm that I have completed this form truthfully and to the best of my ability. *

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