COVID-19 Waiver (Under 18)

COVID-19 Waiver (Under 18)

La Pointe Dance Studio

#10 430 Acadia Drive SW, Calgary, AB




  1. Does the attendee have any new onset (or worsening) of any of the following symptoms?:
    • Fever
    • Cough
    • Shortness of Breath / Difficulty Breathing
    • Sore throat
    • Chills
    • Painful swallowing
    • Runny Nose / Nasal Congestion
    • Feeling unwell / Fatigued
    • Nausea / Vomiting / Diarrhea
    • Unexplained loss of appetite
    • Loss of sense of taste or smell
    • Muscle/ Joint aches
    • Headache
    • Conjunctivitis (commonly known as pink eye)
  2. Has the person attending the activity/facility been investigated or confirmed to have a case of COVID-19?
  3. Has the attendee or anyone in their household travelled outside of Canada in the last 14 days?
  4. Has the attendee had close contact* with a confirmed case of COVID-19 or someone who is ill** in the last 14 days?

* Face-to-face contact within 2 metres. A health care worker in a occupational setting wearing the recommended personal protective equipment is not considered to be a close contact.

** ‘Ill/symptomatic’ means someone with COVID-19 symptoms on the list above.