Wider Opportunities Student Evaluations by ceb49Y


									             Kingston Music Service
                                                                                 Address of participant:
                        Course Booking Form
Please note: we cannot accept a booking for the course unless ALL
parts of this form are filled in. Please fill in one form for each participant
on the course and email the completed forms to:
                                                                                 Contact email address:
Course details:

Name of the course/s you wish to book:                 Date of each course:      Important information about participant:

                                                                                 Does the participant have any special educational needs?
                                                                                 NO YES 
                                                                                 If yes please detail below:

                                                                                 Does the participant have any medical conditions including food
                                                                                 NO YES 
                                                                                 If yes please detail below:
Participant’s details:


Age:                                                                             Is there any other information that you should tell us about the
                                                                                 participant that would help us to ensure that they have fun and safe
Emergency contact
It is critical that we have at least 2 contact numbers
(preferably cell phone numbers please).

First contact:

Second contact:                                                                  Parent/guardian name:

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