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Section A: Member Details
Please complete all sections. Section C must be completed by the Parent/Guardian if member is aged under 18.
First Name*
Last Name*
Preferred name
Date of Birth*

Day
Month
Year
Gender*
Preferred Pronouns
Address Line 1*
Address Line 2*
Address Line 3
Address Line 4
Home Telephone
Member's Mobile Number*
Member's Email*
Are you in*
- School
- College
- Other
What year are you in?*
Other
What school/College*

Section D: Members’ Consent For Photos
I give my consent for photos/footage of me to be taken during youth theatre activities and for them to be used for publicity and for the youth theatre archive*
- Yes
- No

Section E: Website Login and Payment
Please create a Username and Password for the Members' Area of the DYT website
Member Username
Member Email*
Member Password
Enter Password Confirm Password

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I would like to pay by:*
- Online Payment
- Cash or cheque
- I wish to pay in weekly installments online
- I wish to discuss payment, paying by another installment schedule, or any other matter in relation to the above
Membership until September 2026
Price:
Weekly Installment
Price:
Please return to the General Manager at 18 Monague Lane, Dublin 2 by 28 February , of the current year. Please make cheques out to: Dublin Youth Theatre
If you wish to discuss payment or paying by installments, or any other matter in relation to the above, please do not hesitate to contact Sarah Bragg-Bolger, General Manager at info@dublinyouththeatre or 01 874 3687.
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Membership Acceptance Form