Do you have any health issues that we should be aware of, including allergies? *
Your answer
Do you have any barriers to learning that we should be aware of? *
Your answer
Emergency contact information
Please provide names and contact numbers for two people who can be contacted in an emergency.
Name and telephone number of emergency contact no. 1 *
Your answer
Name and telephone number of emergency contact no. 2 *
Your answer
Media consent
Photographs/videos of students may be taken during the course that may be used for marketing and promotional purposes by Gloucestershire Academy of Music, and our partners, including on social media.
Please tick which applies to you: *
Thank you for your booking.
A copy of your responses will be emailed to the address you provided.