Eastbourne Music Centre Registration Form

I wish to register for the Eastbourne Music Centre Open Day

Pupil's Details

Child's First Name

Child's Last Name

Child's Date of Birth

Child's Gender

Which School does your child attend?

Class Name

Current Year Group

Name of your child's music teacher

Is your child a 'looked after child'? This includes children looked after by the local authority, for example with foster carers

Does your child have any special educational needs, disability, or medical conditions that we need to know about?

If yes, please describe

Parent/Carer Details

Title

Name

Address

Email
We will use email as our first point of contact with you

Phone Number 1
(home, work or mobile)

Phone Number 2
(home, work or mobile)

Emergency Contact Phone Number
(home, work or mobile)

East Sussex Music is committed to ensuring that instrument and vocal learning opportunities are available to all children and young people in the county.

If your child has any additional or educational needs, including a disability, and you would like to discuss how we can best meet them, please contact the office on 01273 261540 or esm@brightondome.org

Which Music Group or Ensemble Would You Like Your Child to Experience?

SESSION 1:
9am - 10am

All sessions are an hour except for Young Music Makers

SESSION 2:
10am - 11am

SESSION 3:
11.15am - 12.15pm

All sessions are an hour

None Beginner Flute & Fifes - Pre-Grade 1+ Youth Choir - Year 6+ Silver String Group - Grade 1-Pre-Grade 2 Silver Violin Group - Grade 1-Pre-Grade 2 Junior Single Reed Group - Beginner - Grade 1 Percussion 35 - Grade 3-5

Which instrument does your child play?

How long have they played this instrument?

If your child plays other instruments and/or takes part in other music activities, please give very brief details below

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Photography Statement:

East Sussex Music takes photographs or video during rehearsals, concerts and events. These may be used in publicity material including brochures, programmes, in social media and on our website. For full details, please read the full photographic consent information that you can find at the top of the page.

Please tick to indicate your agreement

Yes, I give consent to use images of my child No, I do not give consent to

You can remove your consent at any point by emailing esm@brightondome.org

In accordance with the 1998 Data Protection Act and the Privacy and Electronic Communications Regulations 2003, and from May 25th 2018, the General Data Protection regulation (GDPR) 2018, ESM/BDBF will hold your details for administrative purposes and to provide you with updates about our work and how you are helping us change lives through music.

Privacy Policy

I have read the Privacy Policy

I agree

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