NJADS Student Pre-Screening Form
Please complete ALL of the following questions 24-hours prior to visiting our studio for dance class each week. Students not completing this questionnaire every time that they attend class at the studio, will not be allowed into the studio for class. The form only needs to be completed once per day if attending multiple classes in one day.


YOU WILL BE DENIED ENTRY INTO THE STUDIO IF YOU DO NOT HAVE A FACE MASK...please bring a face mask with you, and a container for your child to place their mask in while they are in class (dancers may remove their face mask once they are in their 6' x 6' socially distanced box in the classroom). If you do not have a face mask we have them available for $1.

If you are ill or not feeling well, please stay home. See our full COVID-19 Policies and Procedures online in our Studio Portal or your Parent & Student Handbook.

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.
Student's First and Last Name *
What Day is your child attending class on? *
Did your child or family have close contact with anyone with acute respiratory Illness or travelled outside of Ontario in the past 14 days? *
Does your child have a confirmed case of COVID-19 or had close contact with a confirmed case of COVID-19? *
Does your child have any of the following symptoms? Fever, new onset of cough, worsening chronic cough, shortness of breath, difficulty breathing, sore throat, difficulty swallowing, decrease or loss of sense of taste or smell, chills, headaches, unexplained fatigue/malaise/muscle aches, nausea/vomiting, diarrhea, abdominal pain, pink eye (conjunctivitis), or runny nose/nasal congestion without other known cause? *
Is your child willing to wear a mask when entering/exiting 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, within 2-3 weeks of visiting the studio? (So that contact tracing may be done, and to ensure the safety of our other students during that time period.) *
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. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy