Primary caregiver name

Name

Primary caregiver relationship

relationship to performer

Primary contact phone number

Primary contact email

Communication

Describe any communication tools the performer uses/anything that will help us with communication when we first meet.

Favourites

Let us know any favourite songs, activities, themes etc. that we can include in the performer's trial class.

Medical Information

Please describe any medical information relevant to the trial/performer's participation in the class.

Comments

Please include any other relevant information.

Please note

This form is not an enrolment form