Dance Competition Performer Health Declaration
Performer Information
Full Name
Age
Team / Studio Name
Contact Number
Health Status
In the past 14 days, have you experienced any of the following?
Fever or chills
Cough or sore throat
Shortness of breath
Loss of taste or smell
Muscle aches
Others
Do you have any existing medical conditions?
Are you currently taking any medication?
Have you suffered from any injuries in the past 6 months?
Declaration
I hereby declare that the above information is true and correct to the best of my knowledge.
Signature
Date