Holiday Activity - Rock & Pop Band

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Name of child(Required)

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Date of Birth(Required)

Gender(Required)

Sex(Required)

Ethnicity(Required)

School(Required)

Age(Required)

Please enter a number from 7 to 16.

Year Group(Required)

Please enter a number from 3 to 12.

Address(Required)

Street Address Address Line 2 City County Postcode

Name of Parent / Carer(Required)

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Parent / Carer Email(Required)

Booking confirmation email will be sent to this email address.

Phone number(Required)

Location & Holiday Activity(Required)

Bognor Regis (Rap & Lyric Writing)

Crawley (DJ & Music Production)

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Quantity

Please enter a number from 1 to 3.

What instrument does this student play?(Required)

Playing ability(Required)

Any medical information / special educational needs we need to know about?

Any allergies or dietary requirements?(Required)

Please state none if not applicable.

Photo and video consent(Required)

Occasionally we would like to record or photograph sessions and will sometimes use these images on our website and in publicity material. At no time will the name of any child be made public. Please indicate your consent for us to use images of your child by selecting one of the following options.

Yes

Play In A Band