COVID-19 Screening and tracker agreement for Canadian School of dance
#1 - Full Name (of dancer or person/teacher entering CSD)
#2 - Phone Number (for all non-staff)
#3 - Have you had close contact with anyone with acute respiratory Illness or travelled outside of Ontario in the past 14 days?
#4 - Do you or your child have any of the following symptoms: If you answer YES to any of these symptoms, stay at home.
New onset of cough
Worsening chronic cough
Shortness of breath
Decrease or loss of sense of taste or smell
Unexplained fatigue/malaise/muscle aches
Pink Eye (conjunctivitis)
Runny nose/nasal congestion without other known cause
None of the above
#5 Have you watched our COVID-19 Protocol Video? Video must be viewed prior to attending our August convention or classes. To view the video please copy and paste the link below. https://youtu.be/KLmxqJL3WZo
Please verify that you are human
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