CYO: Apply Now

Medical and Emergency Details
Emergency Contact Telephone 1*
Relationship to Student*
Emergency Contact Telephone 2
Relationship to Student
Family Doctor Telephone
Family Doctor Name
Does your child have any medical condition, allergies or recent illness we should know about?
- Yes
- No
Please give brief details and describe any medication required
Is there anything else you'd like to make CYO staff aware of?
- Yes
- No
Please give details

Declarations and Consent
Photography Consent*
We plan to take photos and/or videos for Cumbria Music Hub promotional use. No players will be identified by name.
- I agree to the above
- I do not agree to the above
Declaration
I have read the details of the course and consent to my son or daughter attending. I agree to his or her participation in the activities involved. I acknowledge the need for obedience and responsible behaviour on his/ her part. I consent to my son/ daughter receiving medical attention as instructed and any emergency dental, medical or surgical treatment, including anaesthetic or blood transfusion, as considered necessary by the medical authorities present. I confirm that the contact details given above are to be used in the event of an emergency or in the event of my son/ daughter being returned home for some other legitimate reason and that at least one of the named contacts will be available throughout the duration of the course.
- I agree to the above
Contact Permission*
We may occasionally want to get in touch by email to let you know about events organised by Cumbria Music Hub.
- Yes please, I'd like to hear about Cumbria Music Hub events
- No thanks
Registration Fee*
We require a nominal registration fee of £20.00 for the season.
- I will pay the registration fee of £20 at the first rehearsal

Student Details