Enrolment If you are a human and are seeing this field, please leave it blank. Fields marked with a * are required. Title (Mr/Mrs/Ms) First Name (Parent/Guardian) * Surname (Parent/Guardian) * Address (including postcode) * First Name (Pupil) * Surname (Pupil) * Home Telephone * Mobile * Confim Mobile * Email Confirm Email * School Attended Annything we should know? Age (if under 18) Date of Birth (dd/mm/yy) My preferred choice of Lesson offered is: 1st Choice 2nd Choice Instrument * Guitar Keyboard (piano) Singing Drums DJ Music Production Is there an instrument at home for practice? yesno I, the parent/guardian give consent to Music Gym to take photographs and or video of my child within the context of music lessons/musical performances for use in Music Gym’s promotional materials including print, Music Gym website, Music Gym social media sites and by clicking submit and sending this form I confirm I have read and agree to Music Gym Terms and Conditions. If you are a human and are seeing this field, please leave it blank.