Bangers and Crash Registration Form

RESERVE ME A PLACE!

This form must be completed for each participant
Name of Participant wishing to take part: *

First NameLast Name
Name of person completing this form: *

First NameLast Name
Which event do you wish to participate in?*

If you are applying to join the LIMERICK event please let us know if you are a member/student with any of the following:
Limerick School of MusicIrish Chamber Orchestra Youth / SchoolsRedemptorist Centre of MusicMunster Music AcademyNone of the Above

If you are applying to join the CORK event please let us know if you are a member/student with any of the following:
MTU Cork School of MusicCork Youth OrchestraCork City Music CollegeMusic Generation Cork CityCork ETB School of MusicNone of the above

If you are applying to join the CARLOW event please let us know if you are a member/student with any of the following:
Carlow College of MusicMusic Generation CarlowMusic Generation LaoisMusic Generation KilkennyMusic Generation KildareNone of the Above

If you are applying to join the GALWAY event please let us know if you are a member/student with any of the following:
Maoin Cheoil na GaillimheMusic Generation Galway CityMusic Generation Galway CountyDrumadoreNone of the Above

Age:*
Date of Birth:*

DayMonthYear
Address:*

Line 1

Line 2

City/Town/VillageCounty

Eircode
Participant Email:*
If under 18 yrs enter parent/guardian email
Participant Mobile Number:*

CodePhone Number - If under 18 yrs enter parent/guardian number
Name of the school or college are you attending:*
enter 'n/a', if you are not attending
Are you attending (full or part-time) a Music School or Music College? If yes, please provide the name:*
enter 'n/a', if you are not attending
Are you a member of an orchestra, ensemble or group? If yes please provide the name/s:*
enter 'n/a', if you are not in an orchestra, ensemble or group
What instruments do you play?*
Do you sing?*

No I don't singSometimes, a little bitYes I sing
Briefly, can you tell us about your musical experience:*
How did you hear about this event?*
Please confirm that you are aware of the €20 ticket price to participate in this event. This price include all three days of activities.*

Yes, I am aware and I am willing to payNo I wasn't aware, but I am willing to payNo I was not aware, I am unable to payI have already paid through Music Generation
Shortly we will be sending details of the payment options to the email address you provided above. If you wish to provide another contact please do so here:
Further details of the event will be sent to the email address you provided above. If, in the meantime, you have any questions, please leave your message here:
THANKS FOR SIGNING UP!

We look forward to welcoming you onto this project and we'll be in touch soon.
Should be Empty:

RESERVE ME A PLACE!

THANKS FOR SIGNING UP!