Livefeed - Enrolment Agreement

PRESENTS
Enrolment Agreement

By completing this form, you are providing us with your details for our Livefeed programme.This programme is open to children and young people aged 13-18 years, therefore his form should be completed by a parent/guardian of the participant.

Note: a copy of this document will automatically be sent to you by email when you click ‘submit’ at the end.
Which of our Livefeed events is the participant interested in attending? *
Participant Details
Name of Participant:

First NameLast Name
Name of Band/Act (if different to above)
Age:
Date of Birth (dd/mm/yy):

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Gender:
Address:

Street Address

Street Address Line 2

City/TownCounty
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 name:

First NameLast Name
Mobile Number:
Email address of parent/guardian:
Alternative contact number in the event of an emergency:
Name:

First NameLast Name
Mobile Number:
Relationship to participant:
Music Profile
What is the child/young person’s instrument(s)?(Note: the voice is considered an instrument also!)
Will the performance be delivered in English, as Gaeilge (in Irish) or bilingually?
Does the child/young person attend another of our Music Generation programmes?
Is there something in particular you or your child/young person hopes to achieve from this Livefeed event?
MEDICAL INFORMATION
The following medical information is requested by Music Generation Galway County to assist in ensuring your child/children’s safety while he/she/they attend our programmes and by providing it, you consent to Music Generation Galway County processing the information for that purpose. If you fail to provide details in respect of any medical information relevant to your child while participating in Music Generation’s programmes, Music Generation or its funding partners will not be held liable in contract or tort for any damage/injury arising from any omission or error on your part.
Please list any medical issues which we may need to be made aware of while your child/young person is in our care. Child’s Allergies/Medical Information:
Medications your child is taking and that we should be aware of in the case of emergencies:
Does the child/young person have any special needs?
Note: In relation to children with special educational needs, our Musician Educators will endeavour to collaborate with families and SNA(s) to support participation in the Livefeed sessions in a manner appropriate to the needs of the child or young person concerned.
Parental/Guardian Consent Form
Please find the T&Cs at the link here.
I consent for my child/young person to take part in this Livefeed programme and to adhere to its terms & conditions (as set out above)
PHOTOGRAPHY/VIDEOGRAPHY - MEDIA CONSENT
I agree to my child’s image and/or recording being taken in rehearsal and/or performance to document music tuition/music workshops/music performances. These images/recordings may be used by Music Generation and trusted partner organisations (GRETB, Tusla, Foróige, Youth Work Ireland, Galway Co Co) for press and promotional purposes, including production of a short documentary film (should this arise), digital and social media marketing. Images/videos taken locally may be used for Music Generation national publicity and promotional activities for a period of up to 5 years. After 5years images/video will be retained for archival/research purposes only.
Future Events (keep up-to-date)?
Would you like us to send you details of future programmes and events run by Music Generation Galway County?
SHARING OF YOUR INFORMATION
Are you happy for us to contact you by using the contact details that you have outlined above in connection with tuition?
Are you happy for us to share your contact details as outlined above with the members of Music Generation’s staff who may need to contact you (i.e. Administrators, Musician Educators (tutors) and our Music Development Officer?
FINAL COMMENT
Any general comment or question you wish to share with those overseeing the Livefeed programme?
DATA PROTECTION
Please note: This personal information will be processed and retained in accordance with the GRETB Data Protection Policy and Retention Schedule available on request by email to data.protection:@gretb.ie
For enquiries relating to all Livefeed events specifically, feel free to contact Tracy Bruen: tracy.bruen@gretb.ie

For enquiries or questions on Music Generation Galway County please email or call:

The Music Generation Galway County office

Email: musicgenerationgalway@gretb.ie

Phone: 091 874557

These enquiries can be directed to Eric Cunningham, Music Development Officer for Music Generation Galway County.
Signature
(By pressing submit you assert that you are the legal parent or guardian to the above named child/young person)
Should be Empty:

Enrolment Agreement

Participant Details

Music Profile

MEDICAL INFORMATION

Parental/Guardian Consent Form

PHOTOGRAPHY/VIDEOGRAPHY - MEDIA CONSENT

Future Events (keep up-to-date)?

SHARING OF YOUR INFORMATION

FINAL COMMENT

DATA PROTECTION