Sign up now!

To sign up for a Catch Music session, please complete the form below.

(All information will be kept strictly private and confidential)

[contact-form to=”coordinator@catchmusic.org.au” subject=”New Participant”][contact-field label=”First Name” type=”name” required=”1″][contact-field label=”Middle Name / Surname” type=”text” required=”1″][contact-field label=”D.O.B” type=”date” required=”1″][contact-field label=”Email” type=”email”][contact-field label=”Phone number” type=”text” required=”1″][contact-field label=”Emergency contact name, relationship, number” type=”text” required=”1″][contact-field label=”Postcode” type=”text”][contact-field label=”Do you identify yourself as being a person with disability?” type=”checkbox-multiple” required=”1″ options=”Yes,No”][contact-field label=”Does a carer attend with you? if yes, name and organisation” type=”text” required=”1″][contact-field label=”Would you like Catch Music to use your pictures on social media?” type=”checkbox-multiple” required=”1″ options=”Yes,No”][contact-field label=”Do you have any significant medical conditions? (for e.g. nut allergy)” type=”text” required=”1″][contact-field label=”Which session would you like to attend?” type=”checkbox-multiple” required=”1″ options=”Gosnells,Leederville,Midland,Fremantle,Bayswater ,Mandurah,Mirrabooka / Balga,Subiaco”][/contact-form]