Full Name*

Date of Birth

Contact Number*

Email*

Billing Address:

Address Line 1*

Address Line 2*

Country/Region*

Postcode*

Next of Kin (Full Name)*

Next of Kin Contact Number*

Registering for 1:1 LessonsGroup LessonsAdult SoulEarth ChoirBaby & Todd's Music

Comment preferred lesson times (for 1:1 lessons only)
(eg. After school, lunch break, after work, late evening, weekends etc.)

Only tick this box if you would prefer NOT to be included in group/student photos that may be taken for advertisement & performance purposes

If your details change, please email info@vocalswithgia.com as soon as possible.