Glad Spectrum Music - Waiting List Request
Where did you hear about Glad Spectrum Music?
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About you:
Your name? *
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Your address? *
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Your phone number? *
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Your email address? *
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About your child:
Name of child? *
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Date of birth of child? *
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School attended? *
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Musical preferences of child (if known)?
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Any relevant specific needs of child (including medical conditions)?
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Any other relevant information about child?
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Please tick any statements that apply to your child:
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We will never sell your information or share your information with any third party.
I consent to Hear My Music retaining this information indefinitely, or until I specifically request my information be securely destroyed. *
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