Covid 19 form | The Ballet Academy

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Covid-19 Health Declaration

This form must be completed before attending class

Adults name

Childs name/names

Email

Phone

Please confirm your child or the adult bringing your child will not attend ballet with any Covid-19 type symptoms: fever, cough, sore throat, loss of taste or smell

Please confirm you will not attend ballet if you have been in close contact with a Covid-19 patient in the last 14 days of attending the class

Please let us know if you are happy for us to send your details to the NHS for track and trace if needed

Initials

Date

I declare that the info I’ve provided is accurate & complete and I agree to The Ballet Academy Covid-19 terms and conditions linked below:

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