Participant first name

Participant surname

Date of birth

Full address (include Postcode)

Parent/Guardian first name

Parent/Guardian surname

Parent/Guardian Phone number

Parent/Guardian E-mail address

Any medical details we should be aware of?

Emergency contact 1 (name & tel no)

Emergency contact 2 (name and tel no)

Confirmation Confirmation By submitting this form you are applying for a place at the free studio sessions at ReturnMK and you confirm that you will attend all five sessions on the dates detailed above.

Information Sharing Information Sharing I agree that the information provided can be shared with Return MK for the purposes of safely managing this project.

Photographic Consent - Photography, Film and Audio: Milton Keynes Music Service is part of MK Council and occasionally uses photography for publicity purposes. We would like your permission to photograph/film/record audio of your child for possible inclusion in promotional material, website and other publicity material including social media. We will ensure as far as possible that the images/video/audio are not used inappropriately but by submitting this permission form you accept that should this happen, the council does not accept responsibility. Your contact details will remain strictly confidential. Photographic Consent - Photography, Film and Audio: Milton Keynes Music Service is part of MK Council and occasionally uses photography for publicity purposes. We would like your permission to photograph/film/record audio of your child for possible inclusion in promotional material, website and other publicity material including social media. We will ensure as far as possible that the images/video/audio are not used inappropriately but by submitting this permission form you accept that should this happen, the council does not accept responsibility. Your contact details will remain strictly confidential. I give photographic consent I do not give photographic consent