Band/Musician Registration Form 2012
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1. Jumpers & Jazz in July 2012

If you are a jazz musician and would like to be part of the Jumpers & Jazz in July Festival 2012 please fill in the following questions to register your interest:

1. Your Contact Details

Your Contact Details Name:
Company:
Address 1:
Address 2:
City/Town:
State:
Postal Code:
Website:
Email Address:
Phone Number:

2. What genre of jazz is your act? Please give a detailed description of your act/band. If you have an example of your music please email a music mp3 file and any images jpg files to info@warwickevents.com

What genre of jazz is your act? Please give a detailed description of your act/band. If you have an example of your music please email a music mp3 file and any images jpg files to info@warwickevents.com

3. The Jumpers & Jazz in July Festival will run from 19 until the 29 July 2012.
What dates would you be available to play?

	DD		MM		YYYY	HH		MM	AM/PM
Start Date	The Jumpers & Jazz in July Festival will run from 19 until the 29 July 2012. What dates would you be available to play? Start Date Day	/	Month	/	Year	Hour	:	Minute	AM or PM
End Date	End Date Day	/	Month	/	Year	Hour	:	Minute	AM or PM
Start Date	Start Date Day	/	Month	/	Year	Hour	:	Minute	AM or PM
End Date	End Date Day	/	Month	/	Year	Hour	:	Minute	AM or PM

4. Do you require a performance fee?

Do you require a performance fee?

5. Do you require technical assistance for example sound or lighting? Please specify:

Do you require technical assistance for example sound or lighting? Please specify:

6. Do you require assistance with travel and/or accommodation? Please give details.

Do you require assistance with travel and/or accommodation? Please give details.

7. Total number of persons in the group?

Total number of persons in the group?

Thank you for registering to be part of the Jumpers & Jazz in July Festival 2011. We will be in contact with you shortly.

Band/Musician Registration Form 2012Exit this survey