Participant Name & Surname *

Participant's Year of Birth *

Instrument Category *

If you selected Open Category, please state your instrument (if entering for more than one instrument, please list all instruments)

Name of Music School

Name of Music Teacher

Music Teacher E-mail Address

Music Teacher Contact Number

Parent/Guardian Name & Surname *

Parent/Guardian E-mail Address *

Parent/Guardian Contact Number *

Date & Venue to Participate *

If Laerskool Wierdapark in Pretoria becomes available, would you like to be contacted to move your participation date & venue (dates would be 10-11 July OR 15-16 July TBC by school)? *