Chicago

STUDENT DETAILS (required)

Student First Name

Student Last Name

Student Age

Student Date Of Birth (DD/MM/YY)

Name Of School/College Attended

WORKSHOP SELECTION (required)
I would like to reserve a place for the above student in the following RYDA workshop

School of RockChicago

ADDRESS (required)
Address line 1

Address line 2 (optional)

City/Town

Postcode

Email Address for Correspondence

MEDICAL INFORMATION
If your child has any known medical requirements/conditions or learning difficulties please provide full details here. This is essential so we are able to give the best care to our students. (leave blank if not applicable)

PARENT/GUARDIAN DETAILS (required)

First Name

Last Name

Relationship to Student

Emergency Number

COMMITMENT TO PAYMENT

By completing and returning this form you are signing up your child up to attend the workshop selected above hosted by RYDA. You will be expected to pay the full fee within 14 days of receiving payment details. These will be sent to you by email on submitting your application. Your place will be reserved for 14 days and is not guaranteed if payment isn't made in this time.

MEDIA CONSENT
We would like to photograph our workshop to show students progress and share success. The workshop will also be photographed and filmed. Names of students or any other personal information will NOT be linked to our images or footage.

DATA PROTECTION ACT 1998
PLEASE NOTE - All correspondence from RYDA will be sent out by email.

If you haven't already, it is essential that you complete the mailchimp sign up process to 'opt in' to our mailing list, we are not able to add you ourselves due to GDPR. Once you click SEND below you will be taken to a new page titled 'Complete Registration'. By re-entering your name and email address you will be added to our mailing list. THIS IS A DOUBLE OPT IN PROCESS - Please then look out for an email from mailchimp which will ask you to 'opt in' to our list and ensure you complete the process.

Your information will be kept by mailchimp on the RYDA database and used for future correspondence only. Details will NOT be passed on to third parties.

Please tick to confirm that you agree with these terms and conditions and your information being stored as detailed above.

I consent

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