Parental Consent Form

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Lamp House Music Practice Room

Parental Consent Form – Summer Music School 2017

 

To be completed only when your child’s place has been confirmed by a member of the Lamp House Music team.

Places are not secured until Lamp House Music have received a deposit and completed Parental Consent Form.

 

Summer Music School 2017 - Parental Consent Form

For week beginning Monday 31st July 2017.
  • A. GENERAL CONSENT. I agree to my son/daughter taking part in this event and confirm that he/she is available on the dates/times detailed. I agree to his/her participation in the following activities: Rehearsal Sessions, Songwriting/Guitar Workshops, Recording Sessions and pupil performance. I understand that Lamp House Music holds public liability insurance, which covers the activities organised on this programme.
  • The personal details supplied above will NOT be passed to any third party.
  • Photographs of students participating in 'Summer Music School 2016' may be used for educational and promotional purposes. These may be used in leaflets, booklets or other publications (print and electronic) to promote the Music Schools programme and the outreach activities of Lamp House Music more generally.
  • Does your child have any special dietary requirements?
  • If YES, please give details:
  • Does your child have any requirements relating to culture or faith?
  • If YES, please give details:
  • Does your child have any medical conditions requiring medical treatment or regular medication?
  • If YES, please give details.
  • Does your child suffer from any allergies, including allergies to medication?
  • If YES, please give details:
  • My son/daughter has received a tetanus injection within the last 10 years.
  • I agree to my son/daughter receiving medication as instructed and any emergency medical or surgical treatment, including anaesthetic or blood transfusion, as considered necessary by the medial authorities present.
  • Please use this field for any other details you would like us to know in advance of your child participating in the Summer Music School.