Child #1 Full Name *

First Name

Last Name

Child #1 Birthdate *

MM

DD

YYYY

Child #2 Full Name

First Name

Last Name

Child #2 Birthdate

MM

DD

YYYY

Child #3 Full Name

First Name

Last Name

Child #3 Birthdate

MM

DD

YYYY

In our Family, we also have children who don't attend Mainly Music

Not yet at school

At School

Teenagers

Parents Name

First Name

Last Name

Family Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parents mobile

(###)

###

####

Caregivers Name (if not the parent)

First Name

Last Name

Caregivers Home address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Caregivers mobile

(###)

###

####

How did you find out about Mainly Music? *

Friend/Relative

Advertisement

Website

Other

Church affilliation

From time to time mainly music team members take photos of the fun and action at our sessions. These photos are displayed on posters at mainly music and/or distributed to those in the photos. Also parents and other family members quite often take photos of their children enjoying themselves at mainly music. If you wish to include other children in your photos, please check wtih the team and/or the appropriate adults. If you have any concerns with this, please approach one of the team members to discuss this [look for the blue t-shirts/orange lanyards]. In the event of photographs being taken by the leaders of this mainly music for the purpose of a photo board or promotion of mainly music within the church or community, I give permission for this to occur.

Yes I give permission for this to occur.