Junior Membership

Become a Member of
UpStage Juniors today!

Join the cast of the Loughton Panto for our next exciting production...

Cinderella 2026!!
How many children would you like to sign up for Junior Membership?*
If you wish to sign up more than 3 children, please complete a separate form for additional children, or email Jessie at hello@upstage.org.uk
Child's Name*

First NameLast Name
Date of Birth*

DayMonthYear
Address*

Street Address

Street Address Line 2

TownCounty

Post Code
Please tell us about any medical conditions we should be aware of (including allergies, additional needs, physical disabilities)*
Please type 'None Known' if your child does not have any diagnosed medical conditions, additional learning needs or physical disabilities.
2nd Child's Name*

First NameLast Name
Date of Birth*

DayMonthYear
Address (if different to 1st child)

Street Address

Street Address Line 2

TownCounty

Post Code
Please tell us about any medical conditions we should be aware of (including allergies, additional needs, physical disabilities)*
Please type 'None Known' if your child does not have any diagnosed medical conditions, additional learning needs or physical disabilities.
3rd Child's Name*

First NameLast Name
Date of Birth*

DayMonthYear
Address (if different to 1st child)

Street Address

Street Address Line 2

TownCounty

Post Code
Please tell us about any medical conditions we should be aware of (including allergies, additional needs, physical disabilities)*
Please type 'None Known' if your child does not have any diagnosed medical conditions, additional learning needs or physical disabilities.
Primary Parent/Carer's Name*

First NameLast Name
Relationship to Child/ren*
Address (if different to child)

Street Address

Street Address Line 2

TownCounty

Post Code
E-mail*
example@example.com
Phone Number*
Emergency Contact #2*

First NameLast Name
Relationship to Child/ren*
Phone Number*
Which name would you like us to include when we thank our Members for their support?
This can be the paying adult name/s, family name (i.e. The Smith Family), child's name or something else. If no name is submitted we will use the name of the primary parent/carer.
Photo Permission?*

YesNo
I give UpStage Theatre Company permission to take photographs and / or video of my child during rehearsals/performances. I grant UpStage Theatre Company full rights to use these photographs/videos for fundraising, publicity or other purposes to help achieve the group’s aims.
T's & C's*
Please tick to confirm your chosen membership:*
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Junior Membership£100.00

Quantity

Junior - FREE TRIAL£ Free
1 free trial week. Full membership required if continuing with the show.

Quantity

Total £0.00
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