Open House Registration

INFORMED CONSENT – MINORS UNDER 18
INFORMED CONSENT – ADULTS 18 & OLDER

Given Name*
First Last
Preferred Name
Pronoun (optional)
Email address*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Major Instrument*
The Instrument you intend to study
School*
Grade*
Please indicate "Graduated" if you have completed high school
I wish to have a free private lesson*
- Yes
- No
Hotel Room*
Do you require hotel accommodations for the event? (for participants not local to Brandon)
Gender Identity*
Roommate Preference*
In the placement of participants (under the age of 18) in overnight housing, the School of Music’s practice is to pair participants according to their gender identity. In the case of non-binary students, the School will follow the guidance of the participant. Please note that the School will do their best to accommodate preferences but is unable to guarantee that every request can be accommodated. Please contact Aren Teerhuis at teerhuisa@brandonu.ca or 204-571-7866 if you have any questions or concerns. When reasonably possible, the School of Music will provide accommodations (according to the participant fee structure) for parents/ custodial guardians who are traveling to Brandon in support of participants, especially those who are traveling further than 350 km. Parents may be asked to pay for their portion of the housing fee.
Name of Parent(s) or Guardian(s)*
Parent/Guardian's Email Address*
Parent/Guardian's Phone Number*
Participant's MB Medical #*
Important Information
Please provide any information that would be of use to the supervisors, relative to your child's medical history, allergies, habits, fears, or food preferences, etc.
Payment*
You can pay your $50 registration fee with credit card by calling the School of Music Office at 204-727-9631, or by mailing a cheque made out to Brandon University School of Music to: School of Music, Queen Elizabeth II Music Building, 270 - 18th Street, Brandon, Manitoba, Canada, R7A 6A9. Payment should be received no later than Monday, October 24th.
Informed Consent*
Max. file size: 64 MB.

Please upload a signed copy of the Informed Consent Form found at the top of this page.
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Collection of Personal Information

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Open House Registration

School of Music

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