Brick Lane Music Academy CIC ASN Workshops

Please use the form to request enrolment to the ASN workshops. One of our team will contact you to confirm if there are spaces available.

Family Music Session Enrolment Form

Child First Name

Child Last Name

Date of Birth

Pronouns

Food Allergies

Session

Do they wish to stand during the sessions? Do they wish to stand during the sessions? Yes No

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

Relationship to Student

Address

Telephone

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