Parents Name
*
Email
*
Phone
*
Childs Name
*
Gender
*
Male
Female
Ethnicity
Childs Date of birth
*
-
Day
-
Month
Year
Date Picker Icon
Hair Colour
Black
Brown
Red
Blonde
Dark Blonde
No hair
Eye Colour
Blue
Brown
Green
Hazel
Height in Centimetres
Shoe size
Clothing Size in Years
Skills (eg; ballet, gymnastics, acting classes, BMX, etc.......)
Regional Accent
languages Spoken
Any Experience in acting, dance or modelling
Siblings (only if they are also signing up with us)
Any disabilities
Address
*
Street Address
Street Address Line 2
Town
County
Postal Code
PIctures For website Profile - If you are waiting on professional pictures please upload a temporary shot and make a note in the box below..
*
max size 2mb
max size 2mb
max size 2mb
max size 2 mb
Additional Notes
I the parent/guardian of the above named child agree to abide by the Pixie Model Terms & Conditions (these can be found on the website www.pixiemodels.co.uk) and that all pictures uploaded here can be used, without restriction for the purpose of advertising and promoting Pixie Child Model Agency. Subscription fees will be due 30 days from the above date, one of our bookers will contact you for card details before the application is processed, you then have 30 days to inform us if you do not wish to go ahead.
*
I confirm I have read the Terms & Conditions and agree to the above.
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