FORM

REGISTRATION FORM

The International courses Archi in Villa Baruchello – Summer Music Masterclasses – are open to musicians of all nationalities, without age limits who are members of the Cultural Association Club della Musica . To become a member of the Association, simply fill in the registration form and mark the appropriate registration box.

Info : info.archiinvilla19@libero.it  tel/phone +39 3357313490

FILL-IN AND SEND

STUDENT DETAILS



FM









FOR FOREIGNERS ONLY





ADHESION TO CLUB DELLA MUSICA ASSOCIATION



MASTERCLASS





I WOULD LIKE TO BE ENROLLED IN







DOCUMENTS TO ATTACH


ATTACHMENTS:
I enclose copy of identification document, copy of the proof of payment (the present enrollment will be invalid unless the proof of the payment is attached):
Identity card - front
Identity card - back
Receipt of payment

In case of a minor registered:


Data of both parents exercising parental responsibility or parent data that exercises it exclusively











MOTHER'S INFO













Release for Minors

For the minor child I AGREE I have read and understood the release document for Minors


The application fee is 70 euros. Payment of the Application Fee must be made by bank transfer to the following account:

name of the bank
BANCA BCC PICENA
63821 Porto S.Elpidio Italia

Account info
IBAN IT65W0847469670000170190340
BIC SWIFT ICRAITRRD60

Account Holder
Associazione Culturale CLUB DELLA MUSICA
Via dei Mille n.14 – 63821 Porto S. Elpidio (FM) – Italia

specify in the reason for the transfer:
name and surname of the member of the course;
Course and Master, specifying whether Active or Observer.