Theatre Zone Consent Form

Please complete and click submit, you will then be redirected to the payment page

Your Name



Home Phone Number

Mobile Number

Date of Birth




Any medical information we should have

(please tell us about diabetes / epilepsy / asthma / dyslexia / dyspraxia / aspergers / autism)

Your Start Date




------------------------------- Consent Section -------------------------------

Can we & the press take photos and video of you Yes or No

I give permission for myself to take part in Spotlites Workshops. And I accept that whilst every care will be taken this will be at my own risk. Yes or No

I have read and accept Spotlites rules (click here to read the 'Theatre Zone rules 1 to 3') and agree to give 4 weeks term time week's notice or pay 28 in lieu to stop my membership when the time comes. Yes or No

Should the necessity arise, I give permission for an anaesthetic to be administered to myself or for any other urgent medical treatment to be given. Yes or No

I give permission for these details to be kept on Spotlites' database to aid emergency contact. Yes or No

Your Signature (print name)

Your email address

Please click send below, you will then be redirected to the payment page

We do not share or sell any of our Data to anyone else.

3d_back.gifBack to home

emailpic2.gif e-mail us