Access Registration Form
Access Registration Holder Details
Please enter details of the Access Registration holder. If the Access Registration holder requires someone to book tickets on their behalf, please enter these details on page 3.
Please enter your Access Registration Number:
*
(provided by Nimbus Disability)
Registration Expiry Date:
*
-
Day
-
Month
Year
Name
*
First Name
Last Name
Address
*
House Name/Number
Postcode
Date of Birth
*
-
Day
-
Month
Year
Email
example@example.com
Mobile Number
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Access Requirements:
To help us learn more about your access requirements, please select from the list below:
*
I am a wheelchair user (electric)
I am a wheelchair user (manual)
I require Audio Description
I have a registered assistance dog
I use a wheelchair but prefer to transfer to a seat
I am unable to use stairs for any other reason
I require a seat close to an exit
I need to know about strobe lighting
I am blind or visually impaired
I am D/deaf or hard of hearing and a BSL user
I am D/deaf or hard of hearing and use captions
I need to sit within a hearing loop
I have an access requirement not listed here
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Access Registration Holder Representative
If the Access Registration Holder requires someone to book tickets on their behalf (as they are unable to do this themselves), please provide the representatives details here:
Name
First Name
Last Name
Address
House Name/Number
Postcode
Date of Birth
-
Day
-
Month
Year
Email
example@example.com
Mobile Number
What is your relationship to the Access Registration holder?
Please Select
Parent/Guardian
Friend
Family Member
Registered Carer
Other
Privacy Policy
The Customs House is committed to protecting your privacy. The information you provide will be handling in accordance with the Data Protection Act 1998, Privacy and Electronic Community Regulations 2003 and UK General Data Protection Regulation (UK-GPDR). Please let us know your contact preferences below (please select all that apply)
Access Registration Holder - let us know your contact preferences below (please select all that apply)
I am happy for The Customs House to contact me by Post
I am happy for The Customs House to contact me by Email
I am happy for The Customs House to contact me by Phone
I am happy for The Customs House to contact me by Text
Access Registration Holder Representative - let us know your contact preferences below (please select all that apply)
I am happy for The Customs House to contact me by Post
I am happy for The Customs House to contact me by Email
I am happy for The Customs House to contact me by Phone
I am happy for The Customs House to contact me by Text
Submit
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