1-2 April 2017 at Kennet School

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* 1. Participant's first name

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* 2. Participant's surname

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* 3. Participant's age

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* 4. Medical conditions/Medication

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* 5. Guitar teacher

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* 6. What is the participant's current level of playing?

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* 7. Parent/Carer name (including title)

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* 8. Parent/Carer emergency contact

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* 9. Parent/carer email

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* 10. Do you give us permission to use photos/video of the participant in our external publicity?

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* 11. How did you find out about this course?

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* 12. I agree to you using my e-mail address to contact me:

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