Derksen Photography COVID-19 Intake Form Derksen Photography COVID-19 Safety + Precautions The health and safety of my clients are a top priority. Please know that I am taking all precautions, as I always have, to maintain a clean, safe environment at my studio so that my littlest clients and their families are protected.Name* First Last Names and ages of all participants* Email* Phone*Have you, your child, or any other immediate family member or recent acquaintances tested positive for COVID-19 or any other communicable diseases?* Yes No If yes, when? MM slash DD slash YYYY Do you, your child(ren) or any immediate family members have any of the following?* Fever (defined as above 99.6 degrees)? Cough? Shortness of breath/difficulty breathing? None of the above Consent* I understand that based on the above answers I may be asked to reschedule my session.Consent* I understand and assume the risks of contracting communicable diseases while in close contact with another person.Consent* I hearby fully waive and release DERKSEN PHOTOGRAPHY from any and all claims for personal injury, property damage, illness, loss, expenses and/or death that may result due to the participation in a photography session. Please sign below.Please sign below.* Δ
