First Name (e.g. Katherine):
Known as (e.g. Katy):
Date of birth
Emergency contact * Required (Name, Home phone, mobile phone)
Membership Type: We provide reduced membership fees for anyone in full-time training or education
Gift Aid: If you are a UK taxpayer you can enable us to reclaim tax on your membership fees
Please select which group(s) you wish to join initially.
You can join other groups at any time after you join:
What instrument do you wish to play, OR
what voice part would you like to sing in the choir:
Do you have any accessibility requirements that you would like us to know about?
Please use the box below to provide more information about your accessibility needs and what we can do to help meet them.
Do you have any dietary requirements?
If you selected 'allergies' above please specify below
Please provide any medical information you think we should know about:
Please provide details of any medical qualifications you hold, or any first aid qualifications:
Other Skills and Experience
Please provide details of any relevant other skills or experience
that you would be prepared to contribute to Furness Music Centre (e.g. ability to arrange music, administrative or financial skills, etc):