Course Name

Course Fee

Please enter the Parent/Carer/Contact details below

Parent/Carer/Contact First Name

Parent/Carer/Contact Last Name

Parent/Carer/Contact email address

Emergency Mobile No

Alternative Emergency No

Home Phone No

Street Address e.g. 99 Crispin Drive

Street Address e.g. Woodlands Park

Postal Town e.g. Bedford

County e.g. Bedfordshire

Post Code e.g. MK44 1JR

Please enter the Student details below

I confirm that the student can attend on Saturday 29th October 2022 between 10.00am-4.00pm at Redborne Upper SchoolYN

I confirm that the student can attend on Sunday 30th October 2022 from 11.00am at Bedford Corn ExchangeYN

Student First Name

Student Last Name

Student SexSelect SexMaleFemaleOther

Email address

Mobile No

Which BMT ensemble are you already in, if any?Select EnsembleNoneChamber CourseYouth ChoirYouth Opera

Which other ensembles are you already in, if any?

Instrument e.g. Violin

Standard (Grade equivalent)Select GradeNone12345678

Date of birth if using IE or Firefox browser format as YYYY-MM-DD

School / College

Do you have any medical conditions?YN

Medical Condition Details e.g. special needs, allergies plus details including medicines

Are you happy for photographs/video being taken by BMT to be used solely for BMT marketing purposes?YN

Do you agree to receiving emails from us regarding this/future events?YN

I have read and accept the Terms & Conditions

Clicking on the following button will send the above details to Bedfordshire Music Trust and you will receive an acknowledgement email.

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