Health Declaration

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!

Westside School.

Galena Rd. W6 0LT

Pleasing Dance School of Ballet

020 7794 0905

Email : pleasingdance@googlemail.com

Health Declaration