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Playbox Membership
Application

To apply for any of our weekly workshops, please complete the form below. Please complete one form per child.

Parent's name(Required)

First Name

Last Name

Last name

Parent's Email(Required)

Alternative Email

Mobile Number(Required)

Alternative Phone Number

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Child's Name

First name

Last name

Last Name

DOB

Email (over 16 only)

Medical/Allergy notes

Workshop(Required)

Day(Required)

Time(Required)

Location(Required)

Your information is incredibly important to us, we do not share details and guarantee your privacy. Please feel free to browse our Privacy Policy

“

Your workshops have given my daughter a new lease of life. She has been amazed by what she has achieved”