COVID-19 Declaration Form & Release (Furor)

COVID-19 Declaration Form and Release
**Signature Required Prior to Resuming Dance Classes**
Furor Entertainment Pvt Ltd
and anyone else involved in the operations of the studio's premises, including but not limited to, instructors, visiting faculty and staff (are hereinafter referred to as "Furor").
Age of Consent
What and With Whom are you learning?
Other
Minor Student's Name in Full
Given NameFamily Name
COVID-19 Common Symptoms, as per WHO:
- Fever
- Dry Cough
- Tiredness
I agree to the following:
I affirm that neither I, nor any member of my household, has traveled outside of the country or to any city considered to be a "hot spot" for COVID-19 infections within the past 30 days. Furthermore, I will immediately inform Furor and discontinue classes once I, or any member of my household, returns from traveling outside of the country or to any city considered to be a "hot spot" for COVID-19 infections.
I agree to the following:
I affirm that neither the Student, nor any member of our household, has traveled outside of the country or to any city considered to be a "hot spot" for COVID-19 infections within the past 30 days. Furthermore, I will immediately inform Furor and discontinue classes once the Student, or any member of our household, returns from traveling outside of the country or to any city considered to be a "hot spot" for COVID-19 infections.
Furor will be adhering to the following enhanced procedures to prevent the spread of COVID-19.
Our instructors and staff will…
- Do a temperature check before entering the studio, and ensure that it is below 38.0°C.
- Clean/Disinfect frequently touched surfaces thoroughly and at regular intervals.
- Wash/Sanitize our hands before and after each session.
- Wear our masks at all times.
- Maintain a safe distance at all times.
- Accommodate a limited number of students in each class to ensure physical distancing.
- Schedule classes so as to allow time for cleaning/disinfecting surfaces and allow students to finish and leave the studio before the next set of students arrive.
- Provide sanitizers in the reception area and other locations within the premises.
We are requesting that each of our students, please…
- Allow us to check their temperature before entering the premises to ensure it is below 38.0°C.
- Wear a face mask at all times within the building and within the studio.
- Maintain a safe distance from others at all times.
- Use the hand sanitizer before entering and while exiting the studio.
- Carry their own bottle or cup for drinking water.
By signing below, I agree to each statement above and release Furor from any and all liability for the unintentional exposure or harm due to COVID-19.
Furor agrees to abide by these standards and affirms the same.
Student's Name in Full
Given NameFamily Name
Parent or Guardian's Name in Full
Given NameFamily Name
Mobile Number
Do not include "0" or "+91"Format: 0000000000.
Email ID

Confirmation Emailexample@example.com
Signature
Clear
Please sign above
Date
DayMonthYear
Date of Submission
Should be Empty:

COVID-19 Declaration Form and Release

Furor Entertainment Pvt Ltd