COVID-19 Waiver

Our students’ and staff members’ safety is our top priority. Please take a moment to ensure that you have thoroughly read and completed the COVID Waiver below. If you do not submit this form, you will not be able to enter BCity Reps Dance Studio and the student will not be able to register or attend classes.

Any questions or concerns, please feel free to contact us.

BCity Reps Dance Studio COVID-19 Waiver

Student's Full Name(required)

Phone(required)

D.O.B.(required)

Parent/Guardian (if student is under 18)

Parent/Guardian Phone Number (if student is under 18)

The following COVID-19 Waiver is an agreement between the BCITY REPS DANCE STUDIO ('this Establishment') and those who enter or attend any BCITY REPS DANCE STUDIO sponsored events ('the Attendee'). By signing this agreement, I ('the Attendee'), acknowledge the contagious nature of COVID-19, and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by my mere presence within this Establishment, or at any BCity Reps Dance Studio sponsored events ('Sponsored Events'), and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand the risk of becoming exposed to or infected by COVID-19 may be the result of the actions, omissions, or negligence of myself and others, including, but not limited to employees, volunteers, and program participants, and their families. If I am knowingly exposed, directly or indirectly, to the coronavirus, I will inform this Establishment's director, Kassandra Rateau, as soon as possible, and will not enter this Establishment or any Sponsored Events until I have been cleared by a doctor or have a negative test result. I understand that I will be required to wear a fabric or medical facial mask, covering both my mouth and nose, when entering this Establishment. I understand that I will be required to have my temperature read upon entering this Establishment and will be denied entry with a temperature greater than 100.4. Please enter your full name below confirming this agreement.(required)

I confirm that I have thoroughly read this waiver and I hereby release BCITY REPS DANCE STUDIO and all it's affiliates from all claims arising from or in connection with any direct COVID-19 impact by visiting this Establishment and/or any Sponsored Events for the entire 2021-2022 dance year.(required)

By submitting this form, I certify all information is true and correct to the best of my knowledge (must be completed by Parent/Legal Guardian or student, if under 18 years of age).(required)

COVID-19 Waiver

BCity Reps Dance Studio COVID-19 Waiver

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BCity Reps Dance Studio COVID-19 Waiver

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