Broadway Lights
Covid-19 Self Assessment

1. Are you/is your child experiencing any of the following symptoms?
2. Are you/is your child experiencing any of the following symptoms?
3. Did the dancer receive their final COVID-19 vaccination dose more than 14 days ago?
4. Did the dancer test positive for COVID-19 in the last 90 days and has since been cleared?
5. Is someone that the dancer/child lives with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms? If the individual experiencing symptoms received a COVID-19 vaccination in the last 48 hours and is experiencing mild fatigue, muscle aches, and/or joint pain that only began after vaccination, select “No.”
6. In the last 10 days, has the dancer/child been identified as a “close contact” of someone who currently has COVID-19? If public health has advised you that you do not need to self-isolate, select “No.”
7. In the last 10 days, has the dancer/child received a COVID Alert exposure notification on their cell phone? If they already went for a test and got a negative result, select “No.”
8. Has the dancer travelled outside of Canada in the past 14 days? If travel was solely due to a cross border custody arrangement, select “No.” If "Yes" and the dancer is fully vaccinated, symptom-free and tested negative for COVID-19 following federal requirements, they may come to dance.
9. Has a doctor, health care provider, or public health unit told you that the dancer/child should currently be isolating (staying at home)? This can be because of an outbreak or contact tracing.
10. In the last 10 days, has the dancer/child tested positive on a rapid antigen test or a home-based self-testing kit? If the student/child has since tested negative on a lab-based PCR test, select “No.

Your Health Screening has Successfully been Submitted to Broadway Lights

If you are unable to "SUBMIT" this questionnaire based on the answers you provided, we please ask that you keep your child home and contact your family doctor and Niagara Public Health for further guidance