Please fill out this quick and easy COVID Safety Checklist within 72 hours of attending the premiere of The Motley Experiment.
Mask I agree to wear a mask at all times.
Symptoms Checker By checking this box, I agree to assess myself for COVID-19 symptoms via CDC website: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html prior to coming and I will not attend any show if I have symptoms.
Proof of Vaccination By checking this box, I understand that I will be asked to present proof of vaccination before entering the indoor show.
Notification Prior two attending a show, if you become aware of a positive COVID-19 test/status, you will notify us no less than two weeks after following your visit. Contact us at info@pushdance.org
Signature By checking this box, I consent to signing this form electronically.
Full Name
Email
Δ
