If you are 18 or over please complete this form yourself, otherwise ask your Parent, Guardian or other Adult with Responsibility to complete form

Performer is 18 or over

Performer is under 18 years old

Performers First Name

Performers Last Name

Choir Name (if applicable)

Contact Email/s for information

Phone Number

Any Dietary Requirements

Any Access Requirements

Other requirements / relevant information

Emergency Contact name and telephone number

Song Workshop

Sunday 23rd February

Derby Mickleover Hotel (Best Western)

Etwall Road, Mickleover, Derby, DE3 0XX

If you cannot attend the workshop but want to take part in the concert please still register and just mark below. The learning tracks are on the website, there will also be a rehearsal of the songs on stage on the day and you’ll be singing with over 100 other people.

The workshop will run from 9.30am - 3.30pm with a morning and an afternoon slot. Due to a limit on the maximum number allowed in the venue, the session will be split into morning and afternoon. Each session will follow the same format, the hope is that some people will only want to attend one session so anyone wanting to attend all day can.

In light of this please mark your preference of morning or afternoon below, and also mark if you would want to attend all day if there is enough space.

I can attend the workshop on 23rd February 2025

I cannot attend the workshop on 23rd February 2025

Preferred Session

Morning Session - 9.15 - 12.15

Afternoon Session - 12.45 - 3.45

I want to attend the whole day if there is space

Videoing and Recording Permissions

Please select to allow permission for recording and photographs to be taken at the Workshop and Concerts.

I grant permission for the organization named above to use photographs of me at the Workshop day on 23rd February 2025 or Event on 23rd March 2025 for any of the following purposes: websites or social media accounts, advertisements, promotional publications, articles, other marketing materials, and internal publications.

I grant permission for the organization named above to use recordings of me at the Workshop day on 23rd February 2025 or Event on 23rd March 2025 for any of the following purposes: websites or social media accounts, advertisements, promotional publications, articles, other marketing materials, and internal publications.

I understand that the photographs used online may freely be shared by anyone who has access to internet connectivity and may be published to a local press or media.

I can withdraw the consent I have given at any time. However, I understand that any images already published may not be able to be fully removed from existing materials.

I have the right to access and review any images used and correct any inaccurate information.

I am of legal age to give my consent.

Signatures etc

Name of person completing form

Relationship to performer if under 18 years old

Signature

Use your mouse or trackpad, etc to sign in box, or upload a signature image

Date form completed

A song for everyone 2025 Concert

Chorus Song - a celebration of choirs

Registration Form

Song Workshop

Videoing and Recording Permissions

Signatures etc