music india 2012 - booking application form

8/2/2019 Music India 2012 - Booking Application Form

1/4

Participant Application Form 2012Application Checklist:

All sections of the form filled in correctly

CD/MP3 with music sample OR recorded sample* sent to [email protected]

Contact details of one reference whom we can contact

Name & address of tutor

*Applicable only for non-Samyo and non-Tarang members

Personal Information:

Full name of the participant:

Full name of parent / guardian (if 18 and under):

Male Female Date of Birth: Age:(Date/Month/Year)

(Minimum age 12)*

*Samyo members may be permitted from the age of 10 if accompanied by a parent/guardian

Occupation

Address:

Postcode:

Email:

Tel: Mobile:

Programme Information:

Samyo orchestra course

Tarang ensemble course

Hindustani Music Retreat(Ragas & Compositions for advanced & intermediate students of Hindustani Music)

Carnatic Music Retreat(Ragas & Compositions for advanced & intermediate students of Carnatic Music)

Discover Indian Music

(for musicians of all backgrounds)
mailto:[email protected]:[email protected]


2/4

Mridangam Masterclass

What styles of music and/or instrument have you been trained in and for how long?

How often do you attend classes and how often do you practice?

Please give contact details of the music teacher or the school you have trained in:

How did you hear about Music India 2012? (e.g. through e-mail/web-site/friend/event/other)

Have you attended Music India before? Yes 2008 2009 2010 No

Please provide name and contact details of one reference below. We will contact the referee todiscuss about your musical background:

Additional Information:For administrative purposes, it is vital that we have details about your accommodationpreferences, dietary requirements, condition of health, and emergency contact details.

Accommodation:Accommodation for participants is arranged at Liverpool Hope University Halls, which are oncampus just moments away from the Cornerstone Building where classes will be taught . Allthe rooms are single room with an en-suite.

Do you need accommodation arranged by Milapfest at the Liverpool Hope UniversityHalls?

Yes No

Dietary Requirement:

Are you vegetarian / non-vegetarian/ Vegan? ---------------------------------------


3/4

Do you have any other special dietary requirement? (Please Specify)

-------------------------------------------

Health Information:

Do you have any health problem that we should be aware of? For example: Asthma, Epilepsy,Diabetes, Heart Problem, Allergies (Please specify)

Contact details in case of emergency:

Name:---------------------------------------------------------------------------------------------------------------------------------------------

Land line:--------------------------------------------------- Mobile:----------------------------------------------------

Relationship:------------------------------------------------ Email: ------------------------------------------------------

Terms and Conditions:

Milapfest reserves the right to substitute the teaching faculty advertised or alter the programme,without prior notice to the participant in the event of unforeseen circumstances.

While all reasonable precautions and information will be available for participants to ensure a safeworking environment, Milapfest shall not accept responsibility for loss of property or personalinjury during the programme.

Accomplished, responsible youngsters up to the age of 18 will be admitted to Music India on therecommendation of their teachers which should be provided in a separate letter attached to theBooking Application Form. The admission will be facilitated only if a responsible adult who is a co-participant or a teacher takes charge of their conduct and wellbeing for the duration of Music Indiaprogramme. All other Terms and Conditions herein will also apply.

Please go to next page for declaration.


4/4

Declaration

The above information is correct. I am fit and able to undertake the full time training at Music Indiaand take full responsibility of my well-being. I will withdraw from any activity unsuitable for my levelof ability and fitness.

I agree to the terms and conditions as specified above.

Name & Signature of participants aged over 18

Date:

If you are 18 years or under, the adult responsible for you must complete and sign this section of theform.

I acknowledge, as the adult responsible for the person named above, that Milapfest accepts noresponsibility whatsoever, for accident or injury to that person or damage or loss of their personalbelongings during the programme.

Name & Signature of parent/guardian for participants aged 18 or under

Date:

Booking will be accepted on first come first serve basis. It is your responsibility to ensure yourapplication form and fees reaches us on time. Please email to confirm your application and fees hasbeen received.

Please return this Booking Application Form via e-mail to:Shyla: [email protected] mobile: +44 7985 212310

www.milapfest.com

Music India is produced by Milapfest, the Indian Arts Development Trust andsupported by Arts Council England.

Registered Office:Liverpool Hope University Creative Campus, 17 Shaw Street, Liverpool L6 1HP, UnitedKingdom
http://www.danceindia.org.uk/http://www.danceindia.org.uk/http://www.milapfest.com/

music india 2012 - booking application form

Documents