Club Application

Silverbox Club Application

Club Details

* Indicates required field

Club Type / Day *

Time-slot *

10am - 12pm 1pm - 3pm 3:30pm - 5:30pm

Student(s) Details

Student Full Name *

Sibling Full Name *

Date of Birth *

Medical Information *

Sibling Date of Birth *

Medical Information *

Any other information you think might be useful? *

Contact Details

Parent Name *

Parent Contact Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Permissions

Do you give permission for your child to go home alone? *

Would you like to be added to our mailing list? *

Privacy and Publicity Policy

Terms and Conditions v.2.2.5

Privacy and Publicity Policy *

I confirm that I have read and understood the above Privacy and Publicity Policy and consent to Silverbox Films Ltd using images or video footage material featuring my child, of whom I confirm I am the parent or guardian

Terms and Conditions *

I have read and understood the terms and conditions of business v.2.2.5

Submit Application

Silverbox Club Application

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