Port Fairy Jazz Festival 12th to 14th Feb 2021 - Musician Registration (no fee to register)
Note: Following completion, you will receive an email containing the complete contents of this form - including your responses and our instructions.
* Required
Email address
*
Your email
First Name
*
Your answer
Surname
*
Your answer
Nickname or stage name
Your answer
Phone number (while at festival)
*
Your answer
Alternate phone number
Please provide an alternative if you have on. But for 2021 in particular - If the phone number above does not apply after the festival, please provide an alternate for Government Covid-19 tracing purposes.
Your answer
Address Line 1
*
eg. PO Box number or street address. (For the 2021 festival, this is mandatory for Government Covid-19 tracing purposes.)
Your answer
Town or Suburb
*
Your answer
Postcode
*
Your answer
Instruments Played
*
Separate with commas, Include "vocals" if applicable.
Your answer
Nominated Bands
Indicate below the bands you intend to perform with (maximum 3)
Band 1
*
Your answer
Band 2
Your answer
Band 3
Your answer
Disbursements - Donations
*
Please let us know whether you would like to donate any disbursement which may be payable to the Festival. Such donations will be added to the available disbursement "pool" and divided among participating musicians. In this way your donation helps make attendance at the festival attractive to others and contributes to the growth of jazz in our community.
I will donate my disbursement
I prefer to receive a disbursement
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