Music Club February 2023
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Student name and surname: *
Student age group: *
Student Date of Birth: *
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Parent or guardian name: *
Home address including postcode: *
Email address:
Emergency telephone number: *
Instrument: *
Student level on instrument: *
How many days would your child like attend? *
Please state which days would your child like to attend 10am - 4pm.  *
Required
In case of emergency I consent to Claire Jones and Chris Marshall delivering emergency first aid if necessary. (Please note in an emergency situation we will contact you immediately or the emergency services if required.) *
Name of Doctor and surgery address: *
Does your child have any medical conditions, allergies or intolerances we should be aware of? *
Do you give Claire Jones and Chris Marshall consent to share any photos or videos of your child on the music club course on Tv or social media?
 (If you have any questions please contact Claire)
 *
I confirm my child will bring their musical instrument with them to the club: *
Please confirm that you agree to these terms and conditions:
My child will bring a morning snack, packed lunch and a drink to the Music Club
I agree to drop off my child no earlier than 9.45am, and pick up no later than 4pm as the school will close
 *
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