Workshop Registration Form

Name *

First

Last

Email *

Phone *

Age *

DOB *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Instrument/s of Interest, e.g. vocals, piano, etc *

How did you find out our workshops? *

Would you like to perform to the group/coach for a live critique? *

Yes
No

Comment or Message

Declaration *

Yes, I agree to receive information about Melodique.

Declaration *

Yes, I agree to the below T&Cs.

A workshop event is subject to being postponed, for reasons such as inadequate numbers. If registrations exceed our minimum numbers we will likely propose an additional date or time slot. Payment must be made to Melodique prior to the workshop date. There are no refunds or credits on payment for this event.

Which workshop do you wish to attend? *

Total Amount

$0.00

Stripe Credit Card *

Card

Name on Card

Workshop Registration Form

Workshop Registration Form

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