Right Track Waiting List

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Participant Information

Participant Name*

First name Surname

Participant Age*

Does the participant have any accessibility and/or additional needs you would like to tell us about?

What musical experience does the participant have?*

What would the participant like to gain from taking part in the project?*

Parent/Guardian Information

Parent / Guardian Name*

First Name Surname

Parent/Guardian Address*

Street Address Address Line 2 Postcode

Please check the appropriate box:*

I am the Parent
I am the Legal Guardian

Contact Email Address*

Contact Phone Number*

Photographic and Film Consent

By ticking the box below I agree to give permission for the likeness of my child/young person to be used by Sunderland Culture for the reasons specified above, until such time as I remove my permission. Permission can be removed by contacting daniel.appleby@sunderlandculture.org.uk.

Please read and ensure you are fully aware of the contents of the document before you sign.

As an event participant your child/young person may be photographed and/or recorded on video for evaluation or future promotion purposes. Sunderland Culture or Sunderland City Council may choose to use this material for publicity purposes and these images may appear on social media sites just as Facebook, Twitter and Instagram, in local or national newspapers, or on televised news programmes.

To comply with the UK Data Protection Act 1998, your permission is needed before we are able to use an image or any likeness of your child. No image or likeness will be used without your permission.

If it is given, you may remove your permission at any time by contacting the person named at the bottom of this document.

The form must not be signed by a minor (anyone under 18 years). Permission for a minor must come from a parent or legal guardian.

Please confirm your consent for us to store your answers on this form*

I consent for my data to be collected by Sunderland Culture Ltd and their data processing partners

For more information, please read our Privacy Policy

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