MEMBERSHIP FORM FOR PIRATE PRODUCTIONS (LUXEMBOURG)

Your application is incomplete. Missing or incorrect items are indicated in red

First Name
Last Name
Gender Male Female Non binary
Post Code
Town / City
Country
Nationality
Date of Birth
Phone
Email
Type of Membership
I agree that Pirate Productions can store the above personal information about me.*
one plus seven equals?

* Pirate Productions will not release these details to any other party or use it for any purpose other
than the administraion of Pirate Productions a.s.b.l. Privacy Statement