Expanding Musical Horizons Day with Jess Gillam

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for registering your child for the Expanding Musical Horizons day with Jess Gillam on Monday 11th December 2023. This is open to Players of wind, brass, strings and percussion who are Grade 5 standard and above.

This event will be at Pudsey Civic Hall, LS28 5TA and will run from 9.15am-4.30pm.

Parents and carers will be responsible for dropping off and picking up their child from the event.

Once you have completed the form, you will receive confirmation and further details.

First name *

Surname *

Age *

School attended *

Year group *

Year 5

Year 6

Year 7

Year 8

Year 9

Year 10

Year 11

Year 12

Year 13

Other:

Is your child in a City of Leeds Youth Music Group (CLYM group)? *

Yes

If you selected 'Yes' to being in a CLYM group, please state which group they are a member of:

What instrument does your child play? *

Approximately what level are they? For example, have they been working towards any grade exams. *

Please let us know the name of your instrumental teacher *

Does your child have any medical conditions we should be aware of (e.g. Asthma, allergies)? *

Will you be attending the showcase at the end of the day at 4pm? *

Yes

Parent or carer email *

Name of parent or carer *

Emergency contact name 1 *

Emergency contact phone number 1 *

Emergency contact name 2 *

Emergency contact phone number 2 *

We would like your permission to use any film or images taken of you/ your child in official promotion material such as social media and press releases. Please tick the box: *

I grant permission for my child to be used.

I do not grant permission for my child to be used.

Required

Thank you for completing the form. You will receive a further email to confirm your child's place which will include more details about the day.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms