Little Voices Drama and Singing Lessons of Distinction

This form must be filled out prior to entrance to any Little Voices venue.

This form must be filled out by yourself if you are over the age of 18 or a parent/guardian if under 18

Has anybody who lives in your house been diagnosed with Coronavirus in the last 14 days?*

Anyone who lives in a household with someone who has Coronavirus should self- isolate.
If the answer is yes the person must not attend/will be sent home.
Information
https://www.nhs.uk/conditions/coronavirus -covid-19/self-isolation-and- treatment/when-to-self-isolate-and-what-to-do/

Yes
No

Have you or anybody in your household been advised to self-isolate because you have Coronavirus symptoms?*

Self-isolation means you cannot leave home for any reason.
If the answer is yes the person must not attend/will be sent home.
Information
https://www.nhs.uk/conditions/coronavirus -covid-19/self-isolation-and- treatment/when-to-self-isolate-and-what- to-do/

Yes
No

Have you been advised to self- isolate because you have been in close contact with someone who has tested positive for Coronavirus?*

You will directly help to contain the virus by reducing it’s spread.
If the answer is yes the person must not attend/will be sent home. ,
Information
https://www.gov.uk/guidance/nhs-test-and-trace-how-it-works

Yes
No

Are you or is anyone in your household suffering from flu, high temperature, new continuous cough or loss or change of sense of smell or taste?*

Anyone with symptoms of Coronavirus should self-isolate.
If the answer is yes the person must not attend/will be sent home.
Information
https://www.gov.uk/guidance/nhs-test-and- trace-how-it-works

Yes
No

Have you been advised to self-isolate because you have entered the UK in the last 14 days?*

See approved travel corridors here: https://www.gov.uk/guidance/coronavirus -covid-19-travel-corridors
If the answer is yes the person must not attend/will be sent home.
Information
https://www.gov.uk/uk-border-control

Yes
No

Have you been advised to shield because you are at high risk from Coronavirus (clinically extremely vulnerable)?*

Shielding means you cannot leave home for any reason and is required for anyone considered high risk.
If the answer is yes the person must not attend/will be sent home.
Information
https://www.nhs.uk/conditions/coronavirus -covid-19/people-at-higher-risk/advice-for- people-at-high-risk/

Yes
No

Pupils Name*

First Last

Little Voices Centre*

Date*

Electronic Signature

I confirm that I answered the questions honestly and accurately.

First Last

LITTLE VOICES LIMITED
Registered in England and Wales with company no.06518484
Registered address: 428 Preston Old Road, Blackburn, BB2 5LP
© Little Voices Pupil Enrolment Forms

All Little Voices principals and tutors are fully enhanced DBS checked.
Little Voices is a registered trademark of Little Voices Limited. Little Voices schools and centres are operated as a franchise, LLP or sole trader and are independently owned by the franchisee or individual.

COVID Screening Question

Little Voices COVID- 19 Screening Questionnaire

This form must be filled out prior to entrance to any Little Voices venue.

Contact

Venue

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