Sign up for Music Lessons with Redbridge Music Service

This part of the form is for Parents Information

Your Name (required)

Your Email (required)

Do you currently have an account with Redbridge Music Service eg. instrument hire/ensemble membership (required)
YesNo

Address (Required)

Postcode (Required)

Primary Contact Number (Required)

Emergency Contact Number (Required)

This part of the form is for Pupil Information

First Name

Surname

Date of Birth

Gender
MaleFemaleOther

School

Instrument/Voice

Do you need to hire an instrument through the Music Service Instrument Centre?
YesNo
Please note it is not possible to hire keyboards/pianos/drum kits.

Ethnicity
Select From MenuWhite: English/ Welsh/ Scottish/ Northern Irish/ British IrishWhite: IrishWhite: Gypsy or Irish TravellerOther White backgroundMixed: White and Black CaribbeanMixed: White and Black AfricanMixed: White and AsianOther Mixed/multiple ethnicity backgroundAsian or Asian British: IndianAsian or Asian British: PakistaniAsian or Asian British: BangladeshiAsian or Asian British: ChineseOther Asian or Asian British backgroundBlack or Black British: AfricanBlack or Black British: CaribbeanOther Black or Black British backgroundPrefer not to say

Please let us know of any access requirements we should be aware of (if none, type N/A)

Please let us know of any medical conditions we should be aware of (if none, type N/A)

Is the pupil in the care of the local authority?
YesNo

In this part of the form we are requesting your consent for the following

I consent to my child completing online learning when necessary
YesNo