COVID-19

THE NATIONAL BALLET CONSERVATORY COVID-19 MEASURES & GUIDELINES
Updated 24 September 2020

THE NATIONAL BALLET CONSERVATORY HEALTH DECLARATION

Due to the 2020 Outbreak of the novel Coronavirus COVID-19 The National Ballet Conservatory is taking extra precautions to ensure the care of every student. If you have been exposed to COVID-19 you may spread the disease to The National Ballet Conservatory teachers, staff and other students. Therefore prior to attending each lesson you are requested to complete and sign this form to reduce contagion.

Do you the student, your parents or any anyone you have recently been in contact with have any of the following symptoms?*

FeverCoughShortness of breath/Trouble breathingOther symptomsNo symptoms

Do you the student, your parents or anyone you have recently been in contact with tested positive for or been diagnosed as having COVID-19?*

YesNo

If yes please provide date of illness:

Do you the student, your parents or anyone you have recently been in contact with travelled abroad in the past 14 days?*
YesNo
If yes please provide date of travel and country:

Student Name/Surname:*

Class Name:*

Parent Name/Surname:*

Email:*

Contact Number:*

Date:*

Signature required on the blank space below. To draw your signature use the mouse on PC or finger on Mobile. Forms without signatures will not be accepted.
SIGNATURE:*

I understand my obligation that if the answer is yes to any of these questions. I may be required to attend class online or another time.

MORE INFORMATION ON COVID-19

Read official information about COVID-19 issued by the Maltese Health Authorities GOV.MT

TEACHERS/STAFF COVID-19 HEALTH DECLARATION