Participant's first name

  Participant's last name

  Citizenship

  Date of birth

  Residential Addres

 Guardian's name and surname 

  Guardian's email address

 Guardian's phone number

  Place (school) or form of piano learning, name of piano teacher (if any)

 Years of study

  Age Category

  Program:

•   1. Fairy-tales-themed piece (name of the composer, title and duration)

•   2. Free choice piece (name of the composer, title and duration)

  Participant is not a piano student or graduate of specialistic music school (e.g. conservatory)

 I accept the Terms and Conditions

I hereby give consent to the processing of my and my child's personal data contained in this registration form, as well as photographic and audiovisual materials, by Centrum Artystyczne Muza-Art with headquarters in Wrocław, ul. Morawska 19, 51-111 Wrocław, Poland for the purposes of marketing, advertising and promotions of The 12th International WroClavile Piano Competition, in accordance with Regulation (EU) 2016/679 of the European Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (GDPR). The Controller does not reveal or transfer personal data to a third country. Your consent for processing of personal data can be withdrawn at any time.

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