Oct 25, 2020 09:44 AM
I knowingly and willingly consent to participate in activities with and/or at Studio 365.I confirm that I am not presenting any of the following systems of COVID 19 included but not limited to the following list,
Shortness of breath
Loss of sense of taste or smell
I give Studio 365 consent to take the temperature of any student or parent entering the building and will immediately remove my child if the instructor asks for pick up due any symptoms, and/ or misconduct of not following social distance procedures without refund.
To prevent the spread of contagious viruses and to help protect each other, I understand that I will follow the strict guidelines at Studio 365.
____I verify I am not waiting on results from the COVID-19 test.
____I verify that I have not travelled out of New York State in the last 14 days.
____I verify personal financial responsibility if found deceitful on any above questions, resulting in the loss of work or closure.
At Studio 365 we are following the strict protocols for social distancing and cleaning procedures. As any other public setting, we can not guarantee there will be no exposure to COVID-19 or any other disease.
By signing below you agree to waive any claims of liability against Studio 365 and Staff; to hold Studio 365 harmless if your child contracts COVID-19 despite our efforts to prevent.
Additionally, I agree to notify Studio 365 if my child or any member of our household is exposed to COVID-19 or displays symptoms. This action will ensure the utmost safety of our dancers and staff.
Print Name (Student)___________________________________________
Guardian Name (print) __________________________________________
8514 State Rt. 365, Stittville NY 96 Main St., Camden NY