Youth Music Wessex enrolment form 23/24
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Email *
Personal details
Child's full name *
Child's gender *
Child's date of birth *
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Father's/Guardian's name  *
Mother's/Guardian's name *
Emergency contact name *
Emergency contact phone number *
Home contact details
Address *
Telephone number *
Mobile number *
Email *
Disability/Additional Support
Youth Music Wessex is committed to ensuring that reasonable provision is made for students with disability, health or medical conditions to provide whatever support may be required for additional needs.
Do you have any kind of learning difficulty or disability, which could affect your studies?   *
If yes, please give details
Please continue here if necessary
Allergies and medical 
Does your child have any allergies or are there any medical details we need to know about to keep them safe in lessons and rehearsals?  *
If yes, please give further details
Ensembles 
* Please note that membership of Wessex Youth Symphony Orchestra is subject to a successful audition. Please ensure that you have been through the audition process and been offered a place before applying for this ensemble.
Please tick the group(s) you wish to sign up for
Instruments and ability
N.B. It is not necessary to have taken graded exams, we simply use the grade levels as a playing indicator to ensure youngsters join the appropriate group. 
Instrument 1
Ability level
Instrument 2
Ability level
Theory Class
Enrolment for Music Theory Classes is subject to there being available space in the class. Please ensure you are on the class list before ticking a box. Thank you.
Please tick as appropriate
Recorder Class
There are two recorder classes. The first enables attendance at the grade 2-3 music theory class (if required) and the second enables attendance at the grade 0-1 music theory class (if required) 
Please tick as appropriate
Additional Information
Name of school child currently attends
Where did you find out about Youth Music Wessex?
Clear selection
Consent for photographic, video or audio recordings

I agree to the above named child being photographed/videod/audio taped as part of the activities of Youth Music Wessex (YMWes).

I understand that the photographs may be used as part of a display on a portable information board during public performances/events or online to promote the YMWes, or for use by our sponsors to publicise their support of the YMWes, or for the YMWes' own publicity purposes.

I also understand that the pictures/media may be shown on the YMWes and Wessex Young Musicians' Trust websites and social media forums or via visiting tutors' websites to publicise their own work and support for Youth Music Wessex CIC. I understand that at no time will individuals be named in any such publicity.

I retain the right to request any images of the above be destroyed and, if at any time I wish to withdraw my consent, I will put this in writing to the YMWes Director.
Please tick to indicate your agreement
Name
Date
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For completion by students over 18 years
Please tick to indicate your agreement
Name
Date
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Agreement
I accept that my child's enrolment to Youth Music Wessex is subject to the YMWes 'rules and regulations' - for further information please visit the Policies and Procedures page 
IN CASES OF EARLY WITHDRAWAL FROM YOUTH MUSIC WESSEX, FEES WILL NOT NORMALLY BE RETURNABLE
Please tick to indicate your agreement  *
Required
Name
Date
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Payment 
Payment can be made by cash, in-person card payments (subject to additional card fee) or BACs. Full details can be found on our how to join page.
Data protection
Data Protection Act 1998: The information you provide on this form will be used for the purposes of administration, guidance and monitoring to assist you with your education whilst attending Youth Music Wessex CIC 
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