Please fill in all your contact details to enable us to keep our records completely up to date, including an e-mail address if you have one. Your details will be held by the Society for the length of your membership and will not be divulged to any third party.This form needs to be completed by all Adults and Juniors who are taking part in a production. Your Name Your Email Address Telephone Mobile Do you consent to receiving emails from Ponteland Repertory Society? YesNo Do you consent to your photograph appearing in Ponteland Repertory Society publicity materials? YesNo I have read, understood and agree to abide by the Ponteland Repertory Society & Preppies Youth Theatre Child Protection policy and the Code of Conduct. I Agree Cheques payable to: Ponteland Repertory SocietyOn-line payment to: Ponteland Repertory Society Account No: 53284980 Sort Code: 20-59-97 | Use your first and last name as payment reference. Your Receipt of payment will be acknowledged by our Treasurer via return email to this form submission.Fees: • Membership fee: Adult | £10 per year | There is no junior membership fee • Performance fee: Adults: Musicals/pantomimes £20 / Plays £15.00 per production • Juniors (under 18s/ still in education) £10.00 per productionAll payment and completed membership forms must be submitted online as soon as possible No later than end of September 2018.