Parent / Carer Details

First Name

Last Name

Email *

Phone

Relationship to young person

About the Young Person

Young Person's First Name

Young Person's Last Name

Young Person's Email (Optional)

Date Of Birth

Which day would your young person prefer to attend?

What are they most interested in?

Do they currently play an instrument?

If yes, what instrument(s) do they play?

Do they have access to their own instrument? (Instruments are provided during the sessions)

Is there anything you'd like us to know that could help your young person feel comfortable and get the most from Cairo Amplified?

Confirmations

I confirm that I am the parent/carer of the young person named above and that they are aged 14–17.

I understand that submitting this form registers interest in Creative Connections and that Cairo Amplified will contact me to confirm the next steps