Ensemble/Choir Membership Enrolment Form

for:WYCB

Please complete in BLOCK CAPITALS and return form to Hampshire Music Service (address overleaf)

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Date student attended first rehearsal this term:
STUDENT
Surname: / / First and Middle Names: /
DOB: / / Male / Female
ENROLLING PARENT/CARER
Title:
Surname: / FirstName: /
FURTHER DETAILS
Address and Postcode:
Home Telephone: / / Mobile Telephone: /
Parent email: / / @ /
Student email: / / @ /
For students in Year 11 and under: parents will always be copied into emails sent to the student
School / College attending in Sept 2016 – 17: /
The Arts Council has asked us to collect the following information.
This will be passed on as numbers only and will not be attributed to specific children or families.
Is your son/daughter eligible for Free School Meals?: / Yes / No / / No /
Does your son/daughter have an additional special educational need that is recognised formally within his/her school?:
Yes / No
Name of vocal/instrument teacher: /
OR / Instrument played in this ensemble: /
Vocal Part in this Choir:
Ownership of this instrument(For those joining a choir - please skip this question):
N/A / / Own / School / / Ensemble / HMS / / Serial No. /
IMAGE CONSENT
We would like to useimages and recordings of your child for promotional purposes while they participate in activities and events organised or attended by Hampshire Music Service (HMS).
We may also invite the media to take photographs and/or film footage to publicise these activities and events when it is considered appropriate to do so by HMS. We ask for your permission to use the images and recordings taken of your child in the printed and electronic publications produced by HMS. This includes promotional videos, uploads to the HMS websites and social media sites administered by HMS.Whilst every care will be taken to ensure the images and recordings remain in the context they were taken whilst in HMS publications, it is important for you to be aware that:
  • Websites and social media sites are visible throughout the world, not just in the United Kingdom, where UK law applies.
  • When images or recordings are uploaded to social media sites they will be subject to the terms and conditions of those sites
  • HMS cannot accept any responsibility for the reuse of images or recordings placed on its websites or social media sites

Conditions of use
  • Your consent will remain valid for five years from the date of signing
  • Your consent will end upon the expiration of five years
  • We will not re-use any images after the expiry of this consent
  • We may use group images with very general labels, such as ‘a rehearsal at’ or ‘a performance at’
  • We will not include the name of your child(meaning first name or surname) in any images or recordings without seeking your further consent as appropriate
  • We will only use images of children who are suitably dressed, to reduce the risk of any images being used inappropriately
  • Images taken or recorded by HMS may be transferred to, stored and/or processed at, a destination outside the European Economic Area(for example, using the HMS administered Flickr account). By agreeing to HMS using images/recordings of your child you are confirming your agreement to this transfer, storage or processing

I have read and understood the conditions of use and give consent for my child’s images to be used as described above / Yes / / No /
PERMISSIONS
Would you be happy for us to give out your contact details to other ensemble members and any connected Friends Associations?
(for sharing lifts for example) / Yes / No
Would you be happy for us to contact you, by email or post, about future activities run by Hampshire Music Service. / Yes / No / No /

ENSEMBLE ENROLMENT FORM

Terms and Conditions

The enrolling parent should ensure they have read these terms and conditions before signing this form

  1. For the purposes of these terms and conditions the parent or carer who is enrolling the pupil into the ensemble will be referred to as the customer.
  2. The customer will be the person who signs the enrolment form.
  3. Ensemble members must be in full time education and not exceed 19 years of age.
  4. These terms and conditions form part of the enrolment agreement together with the enrolment certificate.
  5. This enrolment form supersedes any prior agreement between Hampshire Music Service and the customer with regards to membership of an ensemble, whether written or oral. Any and all such prior agreements are cancelled at the commencement date of this agreement.
  6. Hampshire Music Service aims to provide members with an average of 10 hours of rehearsals and one performing opportunity per term, under the leadership of an experienced conductor. Some ensembles may also offer members the chance to attend an annual residential trip at an additional cost.
  7. You will be sent an enrolment certificate by email. This will confirm your child’s membership of the ensemble. The membership of the ensemble will remain in force continuously from term to term unless terminated in accordance with conditions 13,14 and 15 below.
  8. Membership fees are due for a full term or part thereof. Payment of membership fees paid termly by payment on-line should be received by Hampshire Music Service by the due date, which will be on or before the beginning of each term.
  9. For membership fees paid by direct debit, payments will be taken in 12 monthly instalments. The fees for each term will be made as follows: September – December (Autumn term), January – April (Spring term), May – August (Summer term). If your child leaves the ensemble at the end of the summer term in July, the direct debit in August will still be applicable for the last instalment of the Summer term fee.
  10. Hampshire Music Service reserves the right to increase the annual membership fees and will give written notice of any such increase no later than one half term, plus one whole week preceding the term when the increase in fees is due to take effect.
  11. If Hampshire Music Service decides on any occasion to waive fees for any term that the pupil does not attend the ensemble, this shall not mean the Music Service must do so in the future.
  12. Membership fees are all-inclusive for the ensemble rehearsal sessions over an entire academic year, no refunds will be given if individual sessions are cancelled by Hampshire Music Service.
  13. Failure to pay fees on time may result in suspension of a pupil’s membership of an ensemble. Continued failure to pay membership fees may lead to cancellation of the membership.
  14. The customer may terminate membership of the ensemble at any time.
  15. Hampshire Music Service reserves the rightto terminate the membership if the customer has made any misrepresentations to us, whether or not recorded above, or if Hampshire Music Service decides within our absolute discretion that the membership should be permanently suspended. The customer must return any instruments belonging to Hampshire Music Service if requested to do so.
  16. Hampshire Music Service will not accept responsibility for any loss, injury or damage suffered by any person resulting from membership of an ensemble, unless it arises from our negligence, act or default.
  17. Hampshire Music Service will not accept any claim for any loss or damage to a pupil’s own instrument in use during their membership of the ensemble. Pupils’ own instruments are used entirely at their own risk.
  18. Complaints: Any complaints raised by the customer shall be dealt with in accordance with the Hampshire Music Service complaints procedure.
  19. Governing Law and Jurisdiction. This agreement shall be governed by and construed in accordance with the law of England and Wales.

FINAL DETAILS AND PAYMENT
Medical information
Please detail below any current medical information we should know about your child in the event of an emergency.
Please update information as necessary by contacting Hampshire Music Service.
AGREEMENT FROM PARENT
I accept that HMS staff are responsible for pupils during the scheduled rehearsal times
and I confirm that I have responsibility for delivery to and collection from the venue.
PAYMENT ARRANGEMENT FROM SEPT ‘16
Ensemble membership is charged per term. The fee for County ensemble membership is £35 per term; the area ensemble membership fee is £25. If your child is a member of one or more ensembles you will only pay one termly fee.
If your child is a member of an area and county ensemble you only pay one fee of £35 per term.
Please tell us how you would like to pay your fees:
Online (termly): / We will send you a request for payment by email
Direct Debit (12 months): / We will send you a mandate to complete
The information supplied on this form will be recorded in systems belonging to Hampshire County Council; it will be used for recording the membership and emergency contact details of children attending ensemble activities, for planning lessons, recording attendance and monitoring payments.
If you would like to see copies of the information we hold about your child, please contact us at the address below.
AGREEMENT CONFIRMATION
Signature of enrolling parent/carer:
I agree to the terms and conditions of ensemble membership: / Date:

Please return this form to:HMS, Rookwood Centre, Penshurst Way, Eastleigh, SO50 4RJ

If you have any questions - please contact us on 023 8065 2037 or