PLEASE COMPLETE THIS FORM WHEN REQUESTED, IN ADVANCE OF WORKSHOPS AND ACTIVITIES.

MEMBERS – TO AVOID HAVING TO COMPLETE THE FORM EVERY TIME YOU COME IN TO DYT, WE ASK YOU TO COMPLETE IT ONCE BEFORE YOU START BACK TO ACTIVITIES.

KEEP THESE QUESTIONS IN MIND EACH TIME YOU COME IN AND LET US KNOW IF YOUR SITUATION CHANGES. THINK OF FACILITATORS AND FELLOW MEMBERS AND DON’T PUT ANYONE AT RISK IF YOU’RE FEELING UNWELL.

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COVID-19 Declaration Form (Questionnaire)

  • You must complete the following form before attending workshops at the DYT Studio at 18 Montague Lane or other venue.

  • Parent / Guardian Consent

    Parent / Guardian oversight of this questionnaire is required for participants under 18. Please discuss the questionnaire with your young person and sign below. Thank you!
  • QUESTIONNAIRE

    If the answer is Yes to any of the below questions, you are advised to stay at home and seek medical advice. There will be other chances to join events at future dates.
    If yes, please liaise with your doctor (and parent / guardian) re returning to the studio.
  • Date Format: DD slash MM slash YYYY