North Devon Music Centre

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Student Registration Form

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Student Name *

Address

Date of Birth

School/College Attended

Year group

Instrument played *

Instrumental Teacher

Please state which Music Centre ensemble/group you are registering for (if known)

I DO give permission for photographs including my child/children to be used by North Devon Music Centre. I understand that these may appear on website/social media/publicity materials. I understand that NDMC will NOT publish my child’s name.

I DO NOT give permission for photographs including my child/children to be used by North Devon Music Centre.

Please state any medical condition/disability/special education needs: *

Parent Name (if child under the age of 18)

Contact Number

Alternative Emergency Contact Number *

Email Address *

Captcha (spam protection code): *

PARENTAL AGREEMENT (for students up to 18 years old) I agree to my child taking part in the activities of the North Devon Music Centre, including concerts and residential courses (where appropriate). I consider him/her/them capable of taking part in Music Centre activities. In the event of accident or illness I consent to essential treatment if I cannot be contacted.

Note: Fields marked with * are required

Please complete this form as fully as possible. Once received we will email you with details of how to pay your subscription fee.

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