Student name

Date of birth

Parent / Carer name

Phone number

E-mail address

Attendance Attendance I am able to attend this event I am unable to attend this event

Any medical details we should be aware of

Emergency contact 1

Emergency contact 2

Confirmation Confirmation By submitting this form you confirm that you give permission for the above named student to attend the 'Christmas Carols at the Xscape' event on 14 December 2022

Photographic Consent - Photography, Film and Audio: Milton Keynes Music Hub is part of MK Council and occasionally uses photography for publicity purposes. We would like your permission to photograph/film/record audio of your child for possible inclusion in promotional material, website and other publicity material including social media. We will ensure as far as possible that the images/video/audio are not used inappropriately but by submitting this permission form you accept that should this happen, the council does not accept responsibility. Your contact details will remain strictly confidential. Photographic Consent - Photography, Film and Audio: Milton Keynes Music Hub is part of MK Council and occasionally uses photography for publicity purposes. We would like your permission to photograph/film/record audio of your child for possible inclusion in promotional material, website and other publicity material including social media. We will ensure as far as possible that the images/video/audio are not used inappropriately but by submitting this permission form you accept that should this happen, the council does not accept responsibility. Your contact details will remain strictly confidential. I give consent I do not give consent