Amanda's Academy of Dance
COVID 19 Screening
Sign in to Google to save your progress. Learn more
Dancers Full Name *
Does your dancer have any of the following Symptoms? If YES please do not complete this form and do not bring your dancer to AAOD.
Have you or any of your household travelled out of Canada in the last 14 days? If YES please do not complete this form and do not send your dancer to AAOD.
Clear selection
Have you or anyone in your household attended a program or have close unprotected contact (face to face, within 3 metres) with someone who has symptoms of Covid 19? If YES please do not complete this form and do not send your dancer to AAOD.
Clear selection
Have you or anyone in your household attended a program or have close unprotected contact (face to face, within 2 metres) with someone who has medically been diagnosed with Covid 19? If YES please do not complete this form and do not send your dancer to AAOD.
Clear selection
I agree by sending in this form to AAOD that my dancer does not have any Covid 19 Symptoms and I am able to answer NO to all of the listed questions above *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy