New Lodge Arts - Guitar Lessons - Adults
Wednesday - Guitar Lessons - Adults 

Times: 8.00pm - 9.00pm 

Venue: New Lodge Arts Studio - 5 Churchill Street

Dates: Wednesday 17th April - Wednesday 12th June

The cost is £18 for this term or £2 per class. 
Please pay via Paypal on the link provided on this page. 
OR pay the £2 each week at the class. 
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Email *
Participant Personal Details
Full Name *
Date of Birth  *
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Address *
Postcode *
Religion *
Email Address
Home/Mobile Telephone Number  *
Emergency Contact Details
Please provide emergency contact details that are different to the parent guardian who can be contacted, if the parent/guardian is unavailable, details above
Name *
Relationship *
Home/Mobile Telephone Number *
Do you have any additional needs? *
If yes, please give details below
Do you Have Any Allergies or Ongoing Illnesses? If yes give details below *
If yes, please give details below
Health & Safety Statements
Please read the health and safety statements below and tick if you want to give permission for these

I am aware and consent to appearing in any photography/film relating to New Lodge Arts activity/event.  I consent for the photographs/film being used in material promoting New Lodge Arts including the Organisation’s web site and social media. *
I give my consent for the leader in charge to seek medical help from a trained person or professional body should I be hurt or take ill during an Activity with New Lodge Arts *
New Lodge Arts is a subsidiary of Ashton Community Trust. New Lodge Arts and Ashton Community Trust are committed to protection and respecting your child’s information. New Lodge Arts and Ashton Community Trust give assurances that: • Any processing of personal information relating to your child is carried in compliance with the General Data Protection Regulation (GDPR) and the Data Protection Act 2018 (DPA). • Any staff handling personal data are subject to a duty of confidentiality and comply with the obligations under the GDPR and DPA. • Appropriate technical and organisational security measures to ensure compliance with the GDPR and DPA. • The obligations under the GDPR and DPA are met in relation to allowing data subjects to exercise their rights under the legislation. • Report data breaches to the Information Commissioner (if legally required) within 72 hours and co-operate with the ICO as necessary. New Lodge Arts is managed from our office at: Ashton Centre, 5 Churchill Street, Belfast BT15 2BP. If you have any questions in relation to this Privacy Notice or the personal information we have about your child please contact the Data Protection Representative for Ashton Community Trust: Ciara Rea on 02890 322289 Ext: 3118 or alternatively email at Ciara.rea@ashtoncentre.com.To view our full Privacy Notice look on our website at www.ashtoncentre.com/ashton-privacy-notice/  *
I am aware of and give my consent for my  personal information being held on Ashton Community Trust and New Lodge Arts member’s database and understand that all information held will be stored in line with the regulations set out by the General Data Protection Regulation 2018 and will only be accessed by New Lodge Arts and Ashton Community Trust Staff. *
Date Form Completed *
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