MALAYSIAN JUNIOR JAZZ PIANO COMPETITION 2023 ENTRY FORM

Participant’s Name (to be printed on certificate): ______________________________________________________

Date of Birth (dd/mm/yyyy): ______________________ Age (as of 2023): ______

Categories:
A: 5-8 years old
B: 9-12 years old
C: 13-17 years old

Category (please circle): A / B / C

_____________________________________________________________________________________________
Guardian’s Contact Details: (parent OR teacher)

Guardian’s Full Name: ________________________________________________________________

Relationship: Parent / Teacher / Others (please state):________________________

Email (for updates): _____________________________ Tel No: __________________________

Participant's Address: ________________________________________________________________________

Music School Name (if applicable): _________________________________

Teacher/Music School Email (if applicable): _________________________________

Please note:
1. Ensure that the entry video is set to public so that adjudicators are able to access it. Be sure to include the hashtag
#mjpfjuniorjazz2023 when posting.

2. Please remember to pay the Entry Fee of RM50 in addition to the submission of this Entry Form. Any alteration request
after submission will be subject to an additional fee of RM50.

I (guardian/parent’s name), _______________________________________ have read and understand all the terms
and conditions stipulated for the competition and offer consent for my student/child
(name):___________________________________ to participate in the MJPF Malaysian Junior Jazz Piano
Competition 2023.

_______________________________
Guardian’s Signature
Date: