MONITORING: Azucar! Music and Movement

Hello from Rich Mix! Please fill out this form before attending Azucar! Music and Movement. The information you provide here is important for us to reach audiences and communicate with funders so that we can continue to offer as many activities as possible. Rich Mix will store and process your data as per our Privacy Policy, which can be found online at richmix.org.uk/privacy-policy. By giving your consent, you are also consenting to us sharing relevant data with project partner BIMM Institute.

Name of Parent/Guardian:
Address:
Your child/children's name, date of birth, age and school:
Name
DOB
Age
School
 
Do you or your child/children have any SEND or access needs?
Emergency Contact Name:
Are you a Tower Hamlets resident or student?
Do you consent to sharing photographs of your children participating in the session?
Would you like to be added to our mailing list?

About You

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Please choose one of the following options to describe your ethnicity.

Black, Black British or African
Asian or Asian British
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