Dance Class Participant Safety Check-in Form
Please complete this form to ensure a safe and enjoyable dance class experience. Your information helps us provide a safe environment for all participants.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Full Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any existing injuries or medical conditions we should be aware of?
*
No
Yes (please specify below)
If yes, please describe your injury or medical condition.
Have you experienced any symptoms of illness (such as fever, cough, or shortness of breath) in the last 14 days?
*
No
Yes (please explain below)
If yes, please provide details about your symptoms or illness.
Signature (Participant or Parent/Guardian if under 18)
*
Check In
Check In
Should be Empty: