Music Therapy Registration Form
This program is hosted for youth and young adults (16-30) of Victoria. There is NO limit to the amount of sessions each person can sign up to - we run on a first come first serve basis!

Only FOUR spots are available, so we ask that if you cannot make it, you immediately inform sabrina@creansociety.org so someone else can take your spot.

*All personal information collected here will be used for registration purposes only for CREAN & VCM limited specifically to these sessions and will not be shared externally in any way*
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Which session/s would you like to sign up to? *
Required
What is your name? *
How old are you? *
What is your contact information (email or phone number). *
What is your comfort level with using musical instruments?
Not at all
Very
Clear selection
Is there a particular area/struggle that you are interested in working on?
Clear selection
Do you have any accessibility needs / requirements?
What is your emergency contact person's NAME, RELATIONSHIP & CONTACT INFO? *
Sessions will be held in the music rooms at the Victoria Conservatory of Music (VCM). How will you be travelling to and from the VCM? *
Submit
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