1-2 April 2017 at Kennet School

* 1. Participant's first name

* 2. Participant's surname

* 3. Participant's age

* 4. Medical conditions/Medication

* 5. Guitar teacher

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

* 7. Parent/Carer name (including title)

* 8. Parent/Carer emergency contact

* 9. Parent/carer email

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

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

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

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