Music Box Design Consultation Session |

Music Box Design Consultation

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Please complete the form below to participate in the Music Box Design Consultation session, taking place on Saturday 28 February 2026, 11:30-12:30 at Severn Arts, Suite 11, Malvern Gate, Bromwich Road, Worcester, WR2 4BN.
A light lunch will be provided.

Participant details

Name*

First Last

Date of birth*

Participant email

Do you currently participate in Severn Arts activity, and if so, what?

Parent/carer details

This section MUST be filled out if participant is under 18. This acts as permission for your child to take part in the session.

Name

First Last

Email address

Phone number

Emergency contact details

Emergency contact 1*

First Last

Phone number*

Medical Details

This section must be completed by a parent or carer.

Please give any details of medical conditions the participant has, including both physical and mental health.

We will be providing a light lunch for participants. Does the participant have any dietary requirements/ allergies?

Privacy

Filming and photography*

From time to time we may wish to take photographs or film your child, to be used for publicity online and on social media.

My child may be filmed and photographed

My child may not be filmed and photographed

Data consent*

The information you enter into this form will be collected and stored by Severn Arts. Please tick the tick box below to confirm you understand.

I understand

We will always store your personal details securely. We’ll use them to provide the service that you have requested, and communicate with you in the way(s) that you have agreed. You can change your mind at any time by contacting us at [email protected] and by clicking the unsubscribe link in the Mailchimp emails you receive from us. Your data may also be used for analysis purposes, to help us provide the best service possible. For full details see our Privacy Policy By clicking ‘Yes’ below to subscribe to our updates you agree that we may use your information in accordance with these terms.

Keeping in touch*

We’d love to keep you posted with our news, events and activities. Would you like to receive updates from us?

Yes

I’m already on the mailing list

I am particularly interested in:

Receiving the Severn Arts Schools Newsletter

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