CCaafféé MMuusseeA Music Café for Armed Forces Veterans

living with dementia

at The Courtyard, Hereford

August to September 2021 – FREE

orchestraoftheswan.org Follow us on:

The Courtyard

Edgar Street, Hereford HR2 7SG

Designated car parking spaces are located in The Courtyard car park close to the building. Parking is free for all blue badge holders in any space. Blue Badge Holders are asked to log car registration details at the Box Office

11:00 Arrival, Tea & Coffee

11:30 Discussion & Morning Workshop

12.45 Lunch

13:30 Afternoon Workshop

14:30 Tea/Coffee & Wrap Up Discussion

15:00 Departure

Your Café Muse Day

August to September:

FREE

From 6th October:

£7.50 per person (inc. lunch and refreshments)

Café MuseWhat you need to do…

1. Complete the registration form

2.

3.

4.

Client Consent Form

Client’s name: Address: Postcode: DOB: Telephone number: Mobile: Email: YOUR INFORMATION The Orchestra of the Swan (The Swan) will use the information you have provided to carry out the services required. All data will be stored securely and only shared with other organisations with your permission. You have the right to view the data we hold about you or request that some or all your data is deleted at any time. Copies of our privacy notice and privacy statement are available if you require further clarification. If you are happy for The Swan to keep a record of your information and contact details, please tick the box to give consent. The Swan may need to contact other organisations on your behalf and share your information and contact details with them. Please tick the box to give consent. We sometimes produce case studies to help promote and develop our services. Please tick the box if you are happy for a member of our organisation to contact you about this in the future. Please let us know the best way to contact about this service by ticking the boxes below. Post Telephone Email KEEPING YOU INFORMED- MARKETING The Swan would like to keep you informed of news, events, activities and other services we provide. If you are happy for us to do this, please let us know the best way to contact you by ticking the boxes below. Post Telephone Email If you wish to change the way The Swan keep in touch with you, or you wish to be removed from receiving any marketing communication, please contact us using the details below.

Client/Representative signature: Date: If verbal consent is given, please tick the box and date. Date:

Reason For Verbal Consent: The Swan Client Consent Form 160621

14 Rother Street, Stratford-upon-Avon

Warwickshire CV37 6LU

01789 267567

education@orchestraoftheswan.org

Charity number 1068570

recycle for your communityEVERY WEDNESDAY FROM 4 AUGUST

Wed 4 Aug 21 Wed 11 Aug 21 Wed 18 Aug 21 Wed 25 Aug 21 Wed 1 Sept 21 Wed 8 Sept 21

“Getting to

know you”

Our Name & Our Song

Afternoon Tea Week Elvis Week

The Glorious 12th 14th Falklands Day

Being Creative

National Allotments Week National Potato Day

and Bacon Lovers Days (20th)

Sound

Musical Yoga Day National Burger Day

Food

Festival of Learning Have a Go Month

Classical Music Month Merchant Navy Day (3rd)

Categorising Objects

Emergency Services Day

Wed 15 Sept 21 Wed 22 Sept 21 Wed 29 Sept 21 Wed 6 Oct 21 Wed 13 Oct 21 Wed 20 Oct 21

Household Treasures

Roald Dahl Day (13th) Line Dance Week

Current Affairs

World Reflexology Week National

Fitness Day (22nd)

Thinking Cards

Broadway Musicals Day

Visual Clips discussion

International Toot Your Flute Day (4th )

National Poetry Day

Art Discussion

Faces / Scenes Apple Day

World Tripe Day - Sun

Wed 27 Oct 21 Wed 3 Nov 21 Wed 10 Nov 21 Wed 17 Nov 21 Wed 24 Nov 21 Wed 1 Dec 21

Word Games

National Cheese Toastie Day Halloween

Food slogans and Ads

CLOSED Orientation Using Money

Word Game

Wed 8 Dec 21 Wed 15 Dec 21 Wed 22 Dec 21 Wed 29 Dec 21 Thur 6 Jan 22 Thur 13 Jan 22

Household Treasures

13th National Violin Day Christmas Jumper Day

Christmas Party at the

Courtyard

CLOSED FOR CHRISTMAS & NEW YEAR

Open again 6 January 2022

CLOSED FOR CHRISTMAS & NEW YEAR

Open again 6 January 2022

Welcome Back

Number Games

August to September 2021 – FREE From 6th October £7.50 per person (inc. lunch and refreshments)

Weekly Themes and Discussion Topics – This Day in Music.com

Café MuseRegistration Form

Client Details:

Surname: First name: Preferred name: Title:

Address: Telephone:

Mobile:Postcode:

Date of birth: E mail:

Can we leave a message? Preffered Contact Method

Reason for Referral? Service History:

Key Medical Information: Dietary Requirements:

Other Info:

First Point of Contact Details:

Surname: First name: Preferred name: Title:

Address: Telephone:

Mobile:

Postcode:

Relationship to Client: E mail:

Referrer Details:

Self Referral Yes No Preferred name:

(If no, please completed details below)

Address / Organisation: Telephone Number:

Clients consent to contact them Yes No Referrers Email:

Signed: Date

Name:

Statements

I’ve been feeling useful

I’ve been feeling relaxed

I’ve been dealing with problems well

I’ve been thinking clearly

I’ve been feeling lonely

I’ve been feeling optimistic about the future

None of the

time

Rarely Some of the

time

All of the

time

Often

Tell us about yourself, your interests, hobbies and music preferences:

Pverall, how satified are you with your

life Nowadays?

Overall, to what extent do you feel the

things you do in life are worthwhile?

Overall, how happy did you feel yesterday?

Overall, anxious did you feel yesterday?

Not at all Completely

1 2 3 4 5 6 7 8 9 10