Must be completed by dancers, staff & parents upon arrival, before entry into the studio
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Email *
Dancer/Faculty Name: *
Do you have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions. *
Difficulty Breathing
New or Worsening Cough
Sore throat, trouble swallowing
Runny/Stuff Nose or Nasal Congestion
Decrease or loss of smell or taste
Nausea, vomiting, diarrhea, abdominal pain
Not feeling well, extreme tiredness, sore muscles
Have you travelled outside of Canada in the past 14 days? *
Have you come into close contact with a confirmed or probable, positive case of COVID-19? *
A copy of your responses will be emailed to the address you provided.
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