Covid-19 Declaration | Emma Kate Dance

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EMMA KATE DANCE ACADEMY

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Covid-19 Health Declaration / Waiver Form

Please can this be completed prior to the Emma Kate Dance Academy classes, the Emma Kate Dance Academy reserves the right to refuse entry to classes should children be a safety concern to others.

My Child is not experiencing the symptoms; fever, cough, loss of taste / smell

My child and I or anyone in the household have not been in contact with a Covid-19 patient in the last 14 days

We have not visited other countries outside of the UK in the last 14 days

Initials

Date

I declare that the info I’ve provided is accurate & complete

Thanks for submitting!

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