Family Music Session Enrolment Form

First Name

LastName

Date of Birth

Pronouns PronounsHe/HimShe/HerThey/ThemOther

Food Allergies

Permission Permission I give permission for the student to be included in photos taken by the music school during the class that maybe used on social media and other publicity materials.

Parent / Guardian First Name

Parent / Guardian Last Name

Pronouns PronounsHe/HimShe/HerThey/ThemOther

Relationship to Student

Address

Telephone

Email

Mailing List Mailing List I wish to receive emails from Brick Lane Paisley

Terms & Conditions Terms & Conditions I have read the terms & conditions and agree