Register for a Flutterby Music (Medway) class
Your personal data will be collected and used in line with Flutterby Music's Privacy Notice
Child 1 Name *
Your answer
Child 2 Name
Your answer
Child 1 Date of Birth *
MM
/
DD
/
YYYY
Child 2 Date of Birth
MM
/
DD
/
YYYY
If under 18 months: Is your child walking?
Any relevant medical conditions/special educational needs?
By giving details of the above you agree to this statement: "I consent to giving Flutterby Music the following information about my child that may be useful to the teacher in order to include my child fully in classes."
Your answer
Parent Name *
Your answer
Name of person bringing the child to class (if different from above)
Your answer
Address *
Your answer
Email address *
Your answer
Telephone (preferably mobile) *
Your answer
Where did you find out about Flutterby Music classes?
Your answer
Promo code
Your answer
I have read and accept Flutterby Music's Terms and Conditions *
Required
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