Student first name

Student surname

Date of birth

School

Parent / Carer title (Mr, Mrs etc)

Parent / Carer first name

Parent / Carer surname

Phone number

E-mail address

Where do you play your instrument? (i.e. at school? Music Centre?)

Instrument

Grade or standard of playing

Any medical details we should be aware of

Emergency contact 1 (name & tel no)

Emergency contact 2 (name and tel no)

Confirmation Confirmation By submitting this form you confirm that you give permission for the above named student to attend the Brass rehearsals on 16 and 23 March 2022 and the Brass coach trip on 26 March 2022 and accept the charge of £10 which will be invoiced. No refund or credit is available for non-attendance.

Photographic consent Photographic consent I have completed the online photo consent form or have completed and submitted a form previously. Online Photo Consent Form