Galena Rd. W6 0LT
Pleasing Dance School of Ballet
020 7794 0905
Date of Birth
Please indicate below
I confirm that my child is not suffering from any COVID 19 symptoms and have not been for 7 days prior to today. COVID 19 symptoms are defined as having a high temperature, a new continuous cough and a loss sense of taste and / or smell.
I confirm that they have not knowingly had contact with anyone with COVID 19 symptoms within 14 days prior to today.
I confirm that I am not aware of any health condition, which could put my child at greater risk of COVID 19 infection.
I confirm that my child will not attend class should my child or anyone in my household be isolated as a result of illness, local lockdown, change in government advice, or advised to by track and trace personnel.
I confirm that my child will adhere to social distancing throughout the class
Thanks for submitting!