ViBE Dancer Daily Health Screening
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Dancer's First and Last Name *
Parent/Guardian First and Last Name *
In the past 14 days, has the dancer tested positive or been in close contact with anyone who has tested positive for COVID 19? *
Do you have any of the following symptoms or conditions: fever, cough, nausea, vomiting, extreme tiredness, shortness of breath, difficulty breathing, and/or sore throat unrelated to allergies? *
Acknowledgement *
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