2021 Summer term Music Centre online digital lessons Pupil detailsPupil name* First Last Date of birth* DD slash MM slash YYYY Music Centre attending* Name of current Severn Arts instrumental or vocal teacher*If you currently have lessons through Severn Arts, we will endeavour to match your child with the teacher you have named below. Instrument and lesson detailsInstrument*Please state name of instrument or voice. On selecting one of the lesson options listed below, this will then display the number of lessons available, the week the lesson is due to start and the total price.Length of lessons required 20 minutes - individual lesson 30 minutes - individual lesson Cost for 5 x 20 minute individual lessons:Lessons start week beginning 7 June. Price: Cost for 5 x 30 minute individual lessons:Lessons start week beginning 7 June. Price: Parent/carer detailsParent/carer full name* MrMrsMissMsDrProf.Rev. Prefix First Last Email*This must belong to the parent/carer and be the email that will be used for the lessons and all communications with Severn Arts. Home phone number*Mobile phone numberIf different from aboveParent/carer agreementI give permission for my child to participate in online lessons with a Severn Arts teacher. I have read the Severn Arts online lesson guidance/requirements and agree to Severn Arts terms and conditions.*Lesson Guidance and Terms and Conditions Confirm Your privacyThe 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 to. 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 No I am particularly interested in updates about: Music Arts Festivals Cultural education updates for young people Receiving the Arts Newsletter for practitioners Payment summaryTotal - 11 x 20 minutes individual lessons £ 0.00 Total - 11 x 30 minute individual lessons £ 0.00
