Messy + Noisy Workshop — Sign Up Form
Messy + Noisy is run by Southampton Music Hub, a partnership of organisations, which is led by Southampton Music Services, which is part of Southampton City Council.

This form is for Southampton Music Services to request information about participants taking part in the Synthesis Workshop Day on Saturday 23 February 2019.

Please note that, places are limited, and will be allocated on a first-come, first-served basis.

A member of the team will be in touch to confirm your booking, and the whole team hope to see you there!

Email address *
Contact Information
Please provide details of the person completing this form — this person should be over the age of 18.
Contact Name *
Please provide the name of the person completing this form.
Your answer
Messy + Noisy Workshop Participants
Please provide details for the participants in the Messy + Noisy Workshop.
Number of participants *
Please provide the total number of participants taking part in the Messy + Noisy Workshop.
Your answer
Challenging circumstances or additional needs
Messy + Noisy is open to participants of all backgrounds, including children, young people and adults in challenging circumstances, or with special educational or other additional needs. Please use the space below to provide any information that might help the team better understand how they can make all participants feel welcome, and support everyone to participate fully. If you would prefer to discuss this over the phone, please use the space below to provide a phone number, and to suggest days and times that a member of the team could call you.
Your answer
Photographic Permissions Statement
Southampton Music Services is requesting permission to take photographs and/or video of workshop participants.

The resulting images/videos may be used by Southampton Music Services, both internally and publicly, for publicity and fundraising, including printed and online publicity, social media, press releases and funding applications.

Southampton Music Services is the lead partner for Southampton Music Hub and may share the images/videos with its hub partners. A list of hub partners is available online (www.southamptonmusichub.org/about), or on request.

You can change these permissions at any time, however, please be aware, that where images have already been shared publicly (in print and online) that removal of these images may not be possible.

Photographic permissions agreement
Privacy Statement
Southampton Music Hub is led by Southampton Music Services which is part of Southampton City Council.

Southampton City Council is collecting this information in order to perform this service or function, and if further information is needed in order to do so, you may be contacted using the details provided. In performing this service, the Council may be required to share your information with other organisations or departments, but it will only do so when it is necessary in order for the service to be provided.

The Council may also share personal information for the purposes of the prevention, investigation, detection, or prosecution of criminal offences, but will not share personal information, or use it for this, or any other purpose, unless provided for by law. The information provided will be held on file and may also be stored electronically.

More detailed information about the Council’s handling of your personal data can be found in its privacy policy, available online (http://www.southampton.gov.uk/privacy), or on request.

Privacy agreement *
Required
Email newsletters
To receive updates, news and events from Southampton Music Hub, you can sign up to the Southampton Music Hub email newsletter — you can unsubscribe from these emails at any time.
Declaration Statement
I agree to the content of this form and confirm that all the details provided are correct.
Declaration agreement *
Required
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