Gotta Dance - COVID-19 Screening
*THIS MUST BE FILLED OUT THE SAME DAY YOU COME TO THE STUDIO*
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Name *
Email *
Phone Number *
Is your in-studio dance class/rehearsal/event today? *
Required
Today's Date *
MM
/
DD
/
YYYY
Do you have a confirmed case of COVID-19 or are you currently awaiting test results? *
Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? *
In the last 10 days, have you been identified as a “close contact” of someone who currently has COVID-19? *
Have you returned from travel outside of Canada in the past 14 days? (If exempt from federal quarantine requirements because you are fully vaccinated, select “No.”) *
If you are attending the studio for a rental, do you have proof of full COVID vaccination (2 doses)? Please note that the Ontario government is now requiring proof of vaccination for access to non-essential businesses as per O. Reg. 645/21 (section 2.1 of the Ontario reopening guidelines). *
Do you have any of the following new or worsening symptoms? *Please check all that apply* *
Required
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