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.
Email address *
First Name *
Surname *
Nickname or stage name
Phone number (while at festival) *
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.
Address Line 1 *
eg. PO Box number or street address. (For the 2021 festival, this is mandatory for Government Covid-19 tracing purposes.)
Town or Suburb *
Postcode *
Instruments Played *
Separate with commas, Include "vocals" if applicable.
Nominated Bands
Indicate below the bands you intend to perform with (maximum 3)
Band 1 *
Band 2
Band 3
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.
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