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Application Form

Please provide the following information to the best of your knowledge, including any special needs, medical or family issues. All information will be kept confidential.

Personal Details
Name of candidate Age Gender Name of Parent Contact details of parent Address

Telephone Mobile Email

Which of the following activity/activities are you interested in? Please tick: Bharatanatyam 1 Bharatanatyam 2 Kathak Bollywood Tabla Sitar Carnatic Vocal

Previous Experience Does the candidate have: Any previous training If yes, please state the duration of training: Please describe the level of training, e.g name of a step, song or piece learnt previously Yes No

Liverpool Hope University, 17 Shaw Street, Liverpool L6 1HP

Student Agreement I confirm that I am physically able and fit to take part in dance or music training in the Indian Dance and Music School at Liverpool organised by Milapfest. I will be responsible for my personal care and belongings and fully responsible for any injury that I may suffer as a result. If any music CD or DVD is provided to me to assist my music and dance training, I agree to utilise it for personal use only, and will not perform or broadcast it publicly in any performance or showcase without the prior written agreement of Milapfest staff or tutors. Milapfest records video, photo and audio for documentation. This is used for presentation to sponsors, funders, promotional material and potential new audiences. I consent to the use of images strictly for the use by Milapfest for the marketing and promotion of the organisation and its activities as described above. I understand that images will not be used in any other way, or passed on to other organisations without my prior consent.

For parents/guardians of students under the age of 18: As the parent/guardian of the student, please confirm your agreement of the following: I agree to take the responsibility of the students safety, conduct and behaviour before and after classes. I understand that Milapfest will not be responsible for children below the age of 18 before and after classes. (Parents are requested to make sure they are prompt with the pickups for their children after the lessons). Milapfest reserves the right to any change in the term dates and venue bookings in unavoidable conditions.

I confirm that I have read and understood all terms and conditions of this agreement: Student Name: Signature: Parent / Guardian Name: Signature: Date: Liverpool Hope University, 17 Shaw Street, Liverpool L6 1HP