Booking Form Music and Drama Course

booking form

5 Day Music and Drama Course with

Jill Edmonds and Neil Johnson

please fill in the details below :

Please fill in the adjacent form. Please include all relevant information that we may need to know about your child including any health issues or current medication.

To secure your child’s place on the course please pay deposit of: £40.

Total Cost: £175.00

Balance payable by 1st February

Payments by bank transfer to:

Naxos Creative Ltd

Account No: 81416849

Sort Code: 04.00.75

Please add reference:

“February Music and Drama”

Name of child

First Name

Last Name

Age of Child

Name of parent or guardian

First Name

Last Name

Phone No

Emergency Contact No

(###)

###

####

Medical or other health Information

Message

Checkbox

Please tick the boxes below as appropriate

I consent to photographs being taken for publicity purposes

I understand that I need to pay a deposit to secure my child's place

booking form

please fill in the details below :

INFORMATION

CONTACT INFO