Yearly Joining Form
Parents Name
*
Email
*
Phone
*
Childs Name
*
Gender
*
Male
Female
Ethnicity
Family Heritage
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
Is this a twin Appliction?
Yes
Second child
Second Twin Gender
*
Please Select
Male
Female
Second Twin
First Name
Last Name
Second Twin Hair Colour
Black
Brown
Red
Blonde
Dark Blonde
No hair
Second Twin Eye Colour
Blue
Brown
Green
Hazel
Second Twin Height in Centimetres
Second Twin Shoe size
Second Twin Clothing Size in Years
Skills (eg; swimming, 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..
*
Attach Pictures
Drag and drop files here
Choose a file
Cancel
of
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. You have a 30 day cooling of period if you decide this is not for you, just contact a one of our bookers to inform us if you do not wish to continue.
*
I confirm I have read the Terms & Conditions and agree to the above.
*
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Yearly Membership
£165
£
165
Yearly Membership- Baby (under 12mths)
£145
£
145
Yearly Membership-Twins
£165
£
165
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
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