BOOKING FORM

PARENT NAME

EMAIL

MOBILE

NUMBER OF CHILDREN [max 5]

CHILD 1 NAME

CHILD 1 AGE

CHILD 1 PREVIOUS MUSICAL EXPERIENCE

CHILD 1 ALLERGIES/MEDICAL REQUIREMENTS/SEN

ETC

[on the basis that ALL children attend on the same dates]

REQUIRE A MINIMUM OF FOUR DATES PER TERM FOR MEMBERSHIP

DATE 1

DATE 2

DATE 3

DATE 4 ETC TO DATE 10

13-Jan 20-Jan 27-Jan 03-Feb 10-Feb 17-Feb 24-Feb 02-Mar 09-Mar 16-Mar

[payment info]

£60 PER CHILD PER DATE

£20 TERMLY FEE PER CHILD FOR WORKBOOKS TERMLY FEE

WE ACCEPT ALL CHILDCARE VOUCHERS AND ARE REGISTERED WITH THE CHILDCARE GRANT SCHEME

PAYMENT – BANK TRANSFER

SQUARE UP [VINCE PLEASE REGISTEER US WITH SQUARE UP]