Peridance Center COVID-19 Health Screening Survey

Peridance Center COVID-19 Health Screening Survey

Are you taking a dance class with us in-person?

All registrants are required to fill out a health screening survey per class within an hour prior to arrival at Peridance. Students will not be allowed to enter the building until they have completed a COVID-19 Health Screening Survey.

In order to maintain strict protocols under new COVID-19 regulations, Peridance reserves the right to deny entry to any person who arrives late for a class. In order to limit large groups entering the building, it is imperative that each person arrives on time and no earlier than 10 minutes before their scheduled class time. I understand and agree that if I do not arrive within the 10 minute window before my scheduled class time that I will not be allowed to enter Peridance and attend my class. I understand that I will forfeit my place in the class and that I will not be reimbursed nor given credit for the class.

 

- This questionnaire is to comply with the 'Prevention Guidelines of Infectious Diseases for Peridance Center' and is collected from all dancers/students.
- If you make false information or deliberately omit or conceal facts, you may be subjected to penalties or fines.
- You may be restricted from taking a class depending on the responses.
- The collected personal information is used only for epidemiological tracing in the event of a confirmed patient.

Policy

Please read these policies below thoroughly.

Masks:

Peridance requires all persons to wear masks while in the building. Peridance will not accept bandanas, t-shirts or other garments tied around the face, or gaiter neck wraps as appropriate mask coverings, as they are not secure and may fall while dancing. I understand and agree that if I do not arrive at Peridance with an approved mask (no gaiter wrap, no bandana, no t-shirt or other garment tied around face), I will not be allowed to enter the building. I understand that if I arrive at Peridance without a mask that I will forfeit my place in class and that I will not be reimbursed or given credit for the class. 

Late Policy:

In order to maintain strict protocols under new COVID-19 regulations, Peridance reserves the right to deny entry to any person who arrives late for a class. In order to limit large groups entering the building, it is imperative that each person arrives on time and no earlier than 10 minutes before their scheduled class time. I understand and agree that if I do not arrive within the 10 minute window before my scheduled class time that I will not be allowed to enter Peridance and attend my class. I understand that I will forfeit my place in the class and that I will not be reimbursed nor given credit for the class.

High Temperature Policy:

Peridance does not allow persons to enter the building with a temperature at or greater than 100.4 degrees fahrenheit. I understand that if my temperature is at or above 100.4 degrees fahrenheit that I will not be allowed to enter the building or take my class(es). If this happens, Peridance will credit my MindBody account with the class(es) to take at a later time. 

Cancellation Policy:

Cancellations for In Studio classes must be made 24 hours prior to class in order to allow those on the waitlist adequate notice that they have been added to the class schedule. Late cancellations (less than 24 hours before the class) or no shows shall result in a loss of the class. I understand that if I late cancel or do not show up for my scheduled class that I will NOT be reimbursed or credited for the missed class.


I am *
Are you under the age of 18? *
For applicants below 18 years, a Parent/ Guardian will be required. *

Class Information

Time of Class *
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Parent/ Guardian Information

Personal Information

Questionnaire

Have you received a positive COVID test in the past 14 days? *
Have you been in close contact with another person who has received a positive COVID test in the past 14 days? *
Were you advised to self-isolate from the health authority within 15 days as of today, or do you have any family members of housemates who were advised to self-isolate within 15 days as of today? *
Do you have any of the following symptoms? *
Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19.

COVID-19 Liability Release Waiver

The World Health Organization has declared the novel Coronavirus (COVID-19) a worldwide pandemic. Due to its capacity to transmit from person-to-person through respiratory droplets, the government has set recommendations, guidelines, and some prohibitions which Peridance Center, LLC. (the "Organization") adheres to comply.
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I agree to the terms and conditions
I agree to the terms and conditions
By signing below I acknowledge that I have read the foregoing Liability Release Waiver and understand its contents; that I am at least eighteen (18) years old and fully competent to give my consent; That I have been sufficiently informed of the risks involved and give my voluntary consent in signing it as my own free act and deed; that I give my voluntary consent in signing this Liability Release Waiver as my own free act and deed with full intention to be bound by the same, and free from any inducement or representation.

This waiver will remain effective until laws and mandates relevant to COVID-19 are lifted.

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