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Playhaus Membership Form

Thank you for taking the first step to becoming a Patron. Before completing the form, please ensure you have read our policies on privacy and safeguarding.

All questions must be completed. If you are unable to answer, please write 'N/A.'

If you do not hear back from us within 14 days, your application has not been successful.

Email

*

Forename(s)

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Surname(s)

*

Preferred name?

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Pronouns

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Pronouns

She/Her

They/Them

He/Him

Use my name only

Prefer not to say

Other (not listed)

If your pronouns were not listed, please write them below

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Date of birth

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Sexuality

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If your sexuality was not listed, please write it below

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Gender identity

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If your gender was not listed, please write it below

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Social media handle(s)

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Please include any NSFW accounts