Participate as a musician

First name

Last name

Locality

E-Mail

Phone

I can move independently within

I play the following instrument for
(easy to carry)

I am available between the 30/11/2019 and the 26/12/2019 on

between

and

hours

I became aware of the project by

I want to participate in the project for the following reason

(For minor musicians) Consent of the legal representative for the participation in the project

Legal representative name

I declare my participation at the project at my own risk.

I agree my personal data could be collected for the specific needs of the project.

I agree being in photos/film as a record of the day and for promotional purposes of the Fondation EME.

Required fields