REGISTRATION OF INTEREST (For Potential Students)

REGISTRATION OF INTEREST

As this programme is dedicated to children aged 8-14 years (inclusive) a parent/guardian must complete this form on behalf of the child/performer.
SEODA na Gaillimhe is a new junior trad-based orchestra for children across Galway.
- Suitable for 8-14 year olds.
- Open to trad & non-trad performers.
- Suitable for trad & non-trad instruments.
Given the Irish word SEODA means precious items, treasured things or jewels…we look forward to ensuring that SEODA na Gaillimhe becomes a shining example of the potential and talent of the young people of county Galway.

Note: a copy of the information provided here will be sent to you also when you click ‘submit’ at the end.
Where did you learn about SEODA na Gaillimhe ?*
If other, please give details :
What instrument does the performer play? (if more than one, please list in order of experience)*
How long have has your child been learning music (years)?*
Do you consider the performer to be:*

someone who can play Irish traditional musicsomeone who doesn’t play Irish traditional music but would like to be part of such a collaborative orchestra
Please outline any experience (including awards, grades, etc) the performer has to date (if any):*
Does the performer:*

Learn/play by earRead staff notationLearn by other notation methods (i.e. ABCs, trad notation etc)All of the aboveOther
Are you interested in bringing your child to a rehearsal venue:*

Anywhere in Galway County?Within 30 mins of my home?Within one hour of my home?Other
(Note: not all music centres will be close to each applicant.)
Do you have any question(s) you would like to ask at this initial stage?
Student’s Details
Name of student*

First NameLast Name
Age*
Date of Birth (mm/dd/yy):*

MonthDayYear
Date
Gender*

MaleFemaleOther
School Class or Year*
School Name*
Name of music teacher*
Name of music school / programme*
Do you / does your child have any additional needs? Any allergies? Or is there anything else we should be aware of when working with you /your child?
Do you / does your child take part in other Music Generation programmes (please give details if known)?
Note: Music Development Officers are requested (by Music Generation’s National Development Office) to provide a profile of those attending its programmes. These details include ratios of male/females, ages, where students come from etc
Parent/Guardian Details
Parent/Guardian name #1*

First NameLast Name
Mobile Number *
Email address of parent or guardian*
Email
Address*

Street Address

Street Address Line 2

City/TownCounty

EIRCODE
Relationship to Student*
Parent/Guardian name #2 (if applicable)

First NameLast Name
Contact number (secondary to the above)
If we need to contact you, how would you prefer to be contacted? Please note that in the event of an emergency we will telephone the parent/guardian.*

EmailPhone
Permissions
Compliance with GDPR

Music Generation Galway County complies with applicable data protection regulations and is committed to GDPR compliance across its relevant services in accordance with General Data Protection Regulations (GDPR) that came into effect on 25th May 2018. As such, any personal data collected by Music Generation Galway County will be used for no purpose other than that for which it is intended, it will not be shared with any other third party and it will be retained and destroyed as per the Records Retention Policy.
From time to time we may need to contact you regarding our activities to enable your child to take part. For example, we might contact you about scheduling classes, other opportunities to take part, or to give feedback on our programmes. Do you consent to being contacted?*

YesNo
I consent for my contact information to be shared with the staff of Music Generation, when and where necessary.*

I consentI do not consent
Members of SEODA na Gaillimhe may be recorded, filmed and photographed during rehearsals, workshops and concerts by the programme's managers. All SEODA na Gaillimhe members, Parents/Guardians hereby understand that members images may appear in future brochures /booklets /leaflets /posters /flyers etc and video/DVD and or TV presentations /advertisements etc and give consent for their (for members over 18 years of age) images to be used in this way (or that of their child for members under 18 years of age). This applies to a time when they may no longer be involved in the SEODA na Gaillimhe. These images may also be shared and used by partner organisations (including GRETB, Music Generation, Galway County/City Council).*

I consentI do not consent
(By pressing submit you assert that you are the legal parent or guardian to the above named student)
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REGISTRATION OF INTEREST

Student’s Details

Parent/Guardian Details

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