After School Music Group

Name of child / young person *

Date of birth *

Gender *

If other please write below

Address (including postcode) *

School *

Music group(s) you would like to apply for * Choir for Children that are Looked After (Y3-Y6) Guitar Club Intermediate Brass Intermediate Clarinets Intermediate Flutes Intermediate Strings Junior Voices (Choir Y3-Y6) Pad Sessions Rock & Pop Band Skills Sheffield Children's Orchestra (Mercia) Sheffield Children's Wind Band Band (All Saints) Sheffield Children's Wind Band (Mercia) Sheffield Youth Jazz Collective Sheffield Youth Samba Band Sheffield Youth Strings Sheffield Youth Wind Band Youth Voices (Y7-Y13)

Instrument

Name of music teacher (if having lessons)

Emergency contact name *

Emergency contact mobile number *

Second emergency contact name *

Second emergency contact mobile number *

Medical conditions (e.g. allergies, epilepsy, disabilities) which may affect your child during rehearsals

Any additional needs that we need to be aware of

Sheffield Music Hub will also create digital recorded media (including film, photos, audio) throughout the year to document special events, promote Music Hub activities, provide evidence for funders and funding applications, contribute to evaluations, inform parents/carers of a child’s activity when away from home on Music Hub trips, celebrate the diversity of members and musical genre and promote membership.

This media may be shared in the public domain over social media and our website.

These are legitimate interests pursued by the Music Hub and do not override the rights and freedoms of our members.

No action is required from parents/carers. However, you should read our privacy statement and understand your information rights.

Concerts and events: It is expected that parents and carers will be able to take recorded media of their child in performance with other children at publicly advertised events for their personal and private use. We are mindful that some families may have personal reasons for protecting their child’s identity. If you have personal circumstances which would affect your child being recorded please note these below and someone from the team will contact you to discuss this further.

Recorded Media for Children and Young People - Details of Personal Extenuating Circumstances

Do you give permission for your child to leave the music group venue alone (if you tick no then you will need to collect your child from the reception/front door) *

Yes

No

Does your child have a Children's University Passport to Learning *

Yes

No

Would you like to apply for free membership for a child that meets our financial bursary criteria (e.g free school meals) *

Yes

No

Please attach evidence to support your claim

Accepted file types: .doc, .docx, .gif, .jpg, .jpeg, .png, .pdf

Would you like to apply for free membership for a child that is looked after (e.g fostered, in care) *

Yes