Safe Return/Pandemic Waiver
This form acknowledges my intent for the dancer named below to attend in person classes at DANCE INSPIRATION. I have read the information sent via email by Dance Inspiration outlining the new protocols put into place to help prevent the spread of the Covid-19 virus, and promise to follow all procedures and guidelines set.

I agree to monitor my child's health, and will not send my child to class if they, or anyone in the household show any questionable symptoms, including fever, chills, muscle pain, headache, cough, shortness of breath, diarrhea. I confirm my child and members of the household have not shown signs of the above symptoms the past 14 days, and have not been in contact with anyone testing positive for Covid-19.

I understand and consent that if my child is diagnosed with Covid-19, Dance Inspiration may disclose my child's name to local and state health officials, and if necessary, to staff members, other students, or other students' parents/guardians in order to help trace and contain the spread of Covid-19.

I am knowingly and willingly choosing to send my child to participate in classes at Dance Inspiration during the global Covid-19 pandemic. I understand by coming in for classes I am doing so at my own risk and will not hold Dance Inspiration or any of its employees liable for contraction of any illness.
Email address *
DANCER(S) NAME, first/last *
PLEASE ACCEPT the terms stated above. *
Parent/Guardian's Full Name & Date *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy