Decks Plugs & Rock'n'Roll Registration Form
Name:
D.O.B.:
Address:
Sex: Female Male
Email address:
Do you play an instrument already?:
Why do you want to be part of this exciting new project?:
Do you have any medical conditions?:
Do you have a disability?:
Can you provide an emergency contact & telephone number.:
I agree that all information held will be used for monitoring & evaluation: I agree I disagree
Please tick which course are you are interested in.: Blyth Morpeth West Denton
I agree that any photgraphs taken can be used for publicity: I agree I disagree
Which School Do You Attend:
What is the name of your nearest musical instrument shop?:
Please type the text below:
