Permissions / Emergency Contact
To be completed by the parent / carer (or young person themselves if aged 16 or over) this is the 2nd of 2 forms required prior to attending StoMP sessions and activities at our 'home' venue. Please note information will only be used for administration and emergencies, processed securely for StoMP access only. Any questions / concerns please e-mail stockportmusicproject@gmail.com.
Young Person's Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
Date
Which or our activities and sessions would you like your young person to attend?
*
StoMP Reddish
Offerton Youth Music Club
Songwriting Workshop (online)
Music Tech Workshop (online)
Your Name
*
First Name
Last Name
Relationship to Young Person (eg parent, carer)
*
Contactable Email Address
*
Address
*
Number and Street Address
Address Line 2 (optional)
Town / City
County (optional)
Post Code
Contact Phone Number
*
-
Emergency Contact Name (if different from above)
First Name
Last Name
Relationship to Young Person (eg parent, carer)
Emergency Contact Phone Number (if different from above)
-
Are there any medical conditions / other concerns we should be aware of?
*
Do you grant permission for the named young person to attend our sessions and activities?
*
Yes
No
Can you support your young person and enable them to join online music workshops, learning and activities?
*
Yes
No
Do you grant permission for the named young person to be featured in photos and video that will be used to promote Stockport Music Project including on our website, in printed form and social media?
*
Yes
No
Submit
Once received we will print and request that you hand sign this form.
Signature
Should be Empty: