Please use the form below to keep me up to date with your contact information. Student's Full Name(required) Student's Date of Birth(required) Parent/Guardian if Student is under 18 Email(required) Telephone(required) Address and Postcode(required) Emergency Contact (if different from above) Any allergies or medical conditions Any other information (eg additional telephone numbers, email addresses, other instruments played, school information or anything else that may be relevant) I consent to receiving contact from KEBMusicTuition relating to my own lessons, as well as general information about the school (events, promotions, etc.) by Email. Please note this consent must be given in order for tuition services to be provided.(required) Please also contact me by Telephone Please also contact me by SMS I consent to digital photographs, audio and/or video footage being taken by KEBMusicTuition of myself/my child during lessons and performances.(required) Yes No I consent to the above digital media being shared with other students/parents by email (for example as part of a newsletter) and/or publicly online via the KEBMusicTuition website and Facebook page(required) Yes No Submit
