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Halsway Young Folk - Intermediate 2022
Please complete one form for each young musician.
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Applicant first name:
Your answer
Applicant surname:
Your answer
Date of Birth:
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School attended:
Your answer
Home Address
Your answer
Postcode
Your answer
Contact telephone number of parent / guardian (for processing this booking):
Your answer
Contact email for parent / guardian (for processing this booking):
Your answer
What instrument(s) do you play? And to what level?
Your answer
Do you play in any groups / bands / orchestras etc? Please tell us about this here:
Your answer
Accommodation: Do you have friends applying who you'd like to share a room with? (We will try to fulfil these requests but cannot always guarantee them).
Your answer
Diet: Please tell us if you are vegetarian / vegan / have any food allergies / special dietary requirements:
Your answer
Access & Health: Do you have any access requirements, or medical conditions which we need to be aware of in order to facilitate your safe and enjoyable visit?
Your answer
If there is there any other relevant information about yourself / your needs that you'd like us to know about, please include it here:
Your answer
Please provide contact details of 2 people who we can contact in an emergency. FIRST CONTACT - (Name, phone number, email, and relationship to the applicant):
Your answer
SECOND CONTACT - (Name, phone number, email, and relationship to the applicant):
Your answer
PARENT / GUARDIAN TO COMPLETE: Name
Your answer
PARENT / GUARDIAN TO COMPLETE: Relationship to applicant
Your answer
As the parent / guardian I am satisfied with the details supplied regarding all Halsway Young Folk activities and agree for my child / ward to take part in them.
In the event of a minor accident, I agree for First Aid to be administered by a qualified First Aider
I agree to my child being taken to hospital, or to being seen by a doctor should an emergency arise.
I give my consent for photos / videos of my child participating in Halsway Young Folk activities to be used for monitoring / evaluation purposes.
I give my consent for photos / videos of my child participating in Halsway Young Folk activities to be used for publicity purposes (eg Halsway Manor brochure, website and / or social media.)
I give permission for my child to be taken offsite for local activities (eg. for walks).
Date:
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