Membership form

Membership Form 2024-2025
Type of membership
Name of Member

First NameLast Name
Name of Parent / Carer (Junior Members Only)

First NameLast Name
Postal Address
Preferred Telephone Number
Alternative Telephone Number (optional)
Email address [this should be the email address of the parent/carer for junior members] [email will be the standard means of communication with the membership]

Confirmation EmailConfirm email
Date of Birth (Junior members only)

DayMonthYear
2 digit day, 2 digit month, 4 digit year
I agree that any picture, image, video or DVD in which I or any of those named above may feature may be published on a web site, or such other place as may be determined appropriate, for the purposes of record, promotion or fund-raising, at the sole discretion of the Executive Committee.

I consent to the details as given above being held on a database and being used by the Society in accordance with the provisions of the Data Protection Act 2018. I will advise the Society promptly of any changes to these details.

I acknowledge safe receipt of the note for parents and carers [junior members only] and consent to my child taking part in the Society’s production(s).
Please confirm your agreement
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit year
Should be Empty:

Membership Form 2024-2025