CoMA 30th Anniversary Registration Form Please complete this registration form if you would like to take part in CoMA's 30th anniversary weekend - 15/16 July 2023. This form needs to be completed by all participants (including all current CoMA ensemble members). Your Registration Info (CoMA30) First Name * Last Name * Email * Instrument/Voice * - select Instrument/Voice - accordion bagpipes Bandoneon banjo bassoon bouzouki cello clarinet clarinet (alto) clarinet (bass) composer concertina conductor cor anglais crumhorn double bass drum dulcimer elect elect (sonic) euphonium flugelhorn flute guitar guitar (bass) harmonica harp harpsichord horn horn (English) horn (French) hurdygurdy kanun keyboard lute mandolin melodica music tech oboe organ percussion piano piccolo recorder sax sax (alto) sax (bar) sax (sop) sax (ten) synthesizer timpani trombone trombone (bass) trumpet trumpet (cornet) tuba ukelele vibraphone viola violin voice voice (alto) voice (bar) voice (bass) voice (mezzo) voice (sop) voice (tenor) Other instrument If other instrument, please specify Are you a current member of a CoMA Ensemble or Associate Ensemble? * Yes No If yes, which ensemble(s) are you a member of? Do you have any dietary requirements? Do you have any access requirements? I give my permission to appear in photos/videos taken during the event. I understand these will be used on CoMA's social media and website. * Yes No We can provide limited accommodation with CoMA London members. Do you require this? * Yes No Please provide an emergency contact Name * Phone * Is there anything else you require assistance with? Age * - select Age - under 16 16-24 25-34 35-44 45-54 55-64 Over 65 Ethnicity * - select Ethnicity - White British White Irish Gypsy, Roma or Irish Traveller Any other White Background White & Black Caribbean White & Black African Whit & Asian Any Other Mixed Background Indian Pakistani Bangladeshi Chinese Any other Asian Background Black African Black Caribbean Any other Black Background Arab Latin American Any Other Ethnic Background Prefer not to say What is your country of residence? * - select - United Kingdom Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Carribean Netherlands - Bonaire, Sint Eustatius and Saba (Netherlands Special Municipalities) Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo, Republic of the Congo, The Democratic Republic of the Cook Islands Costa Rica Côte d’Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran, Islamic Republic of Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic of Korea, Republic of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States of Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Macedonia Northern Mariana Islands Norway Oman Pakistan Palau Palestine, State of Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (French part) Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Serbia and Montenegro Seychelles Sierra Leone Singapore Sint Maarten (Constituent Country of the Netherlands) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Southern Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe If you reside in the UK, what is your current postcode? Gender * - select Gender - Female Male Nonbinary Other Prefer not to say Are your day to day activities limited because of a health condition or disability? * - select - No Yes, day to day activities limited a little Yes, day to day activities limited a lot Prefer not to say Do you identify as neurodivergent? * - select - No Yes Prefer not to say -- The concession rate is for anyone who cannot afford the full rate and if you would like to participate but are unable to cover the concession rate, please contact info@coma.org If you have a discount code, enter it here Apply Registration Fee * Full - £ 25.00 Concession - £ 20.00 Total Review your registration