Participant Information Form

Please fill in the Participant Information Form below to complete your registration to the Community Choir:

If you are yet to purchase your membership, please do so before completing this form.

* Denotes a mandatory field

Personal details

First name: *

Last name: *

Email address: *

Address: *

Postcode *

Phone number: *

Mobile number:

Date of birth: *

Emergency contact details

Full name: *

Relationship to you: *

Phone number: *

Do you have any health conditions you wish to disclose? *

Yes
No

Please specify: *

Do you have any allergies? *

Yes
No

Please specify: *

Do you have any access requirements? *

Yes
No

Please specify: *

Community Choir participants will have the opportunity to perform at the end of the term. The performance may be photographed and filmed for marketing purposes. Do you consent to photographs and videos of you being taken and used for publicity? *

Yes
No