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Home ycow2021studentregistration

ycow2021studentregistration

Youth & Community Orchestral Workshops 2021
Student Registration

Name *

First

Last

Registration Payment Reference *

Instrument *

Playing Proficiency AMEB Equivalent *

Residential Postcode *

Email *

Email

Confirm Email

Contact Number *

Date of Birth *

School

Instrumental Teacher's Name *

Instrumental Teacher's Email *

Email

Confirm Email

Instrumental Teacher's Telephone *

Media Release Agreement *

I AGREE to waive any and all rights, now and in the future, to any and all audio, visual and audio-visual recordings made by or on behalf of Ipswich City Orchestras Inc in relation to the workshops and public performance which may then be used by The Association in the conduct of their activities in perpetuum.

Use of Images - Select One *

I CONSENT to the use of my / my child’s image in the conduct of the Association’s activities including but not limited to social media, news media and the ICOs Inc website.
I DO NOT CONSENT to the use of my / my child’s image in the conduct of the Association’s activities including but not limited to social media, news media and the ICOs Inc website.

Use of Name *

I CONSENT to the use of my / my child’s name in the conduct of the Association’s activities including but not limited to social media, news media and the ICOs Inc website.
I DO NOT CONSENT to the use of my / my child’s name in the conduct of the Association’s activities including but not limited to social media, news media and the ICOs Inc website.

Parent / Guardian Name or Name if over 18 years *

First

Last

Checkboxes *

I am the Parent/Guardian of the child registered on this form
I am 18yrs or over and can sign on my own behalf.

Acknowledgement *

Please note you will be required to sign this completed form as part of the registration process at the event, prior to you or your child participating in the workshops.

How did you hear about the Workshops? *

Facebook
Instagram
News Media
Music Teacher
Other

Other

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Postal Address

Mail Address
PO Box 215
Ipswich QLD 4305

Contact Emails

president@ipswichcityorchestra.com.au

vicepresident@ipswichcityorchestra.com.au

treasurer@ipswichcityorchestra.com.au

admin@ipswichcityorchestra.com.au

conductor@ipswichcityorchestra.com.au

concertmaster@ipswichcityorchestra.com.au

iyo@ipswichcityorchestra.com.au

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