Access List Registration - Southwark Playhouse

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Access List Registration

Access Membership Form

Full Name *

Email Address *

Address *

Address

Address

Address

City

City

County

County

Post Code

Post Code

Contact Number *

Who are you registering for? *

Myself

Someone else (please give their full name):Someone else (please give their full name):

Should we register them using the above contact details? *

Yes

No

Proposed Access Member’s Email Address *

Proposed Access Member’s Address *

Proposed Access Member's Address

Proposed Access Member's Address

Proposed Access Member's Address

City

City

County

County

Post Code

Post Code

Proposed Access Member’s Contact Number *

What is the nature of your access requirement? *

I require the use of a wheelchair space

I will be transferring out of my wheelchair

I would benefit from being admitted into the auditorium early

I require a seat near the stage

I require an aisle seat

I require a seat close to an exit

I require a seat with step-free access

I have reduced mobility

I’m blind or visually impaired

I’m D/deaf or hard of hearing

I identify as Neurodivergent

I have photosensitivity/light sensitivity

I experience seizures

I may make involuntary sounds or movements

I use a walking aid

I require a booster seat

I require ear defenders

I will be accompanied by an assistance dog

I would benefit from an audio-enhancement headset (available at Elephant only)

I require the use of an Evac Chair in an emergency / I am unable to vacate the building independently in an emergency evacuation

I have other access needs (please specify):I have other access needs (please specify):

Tick as many boxes as are relevant

What is the nature of the access requirement for the person you are applying for? *

They require the use of a wheelchair space

They will be transferring out of their wheelchair

They would benefit from being admitted into the auditorium early

They require a seat near the stage

They require an aisle seat

They require a seat close to an exit

They require a seat with step-free access

They have reduced mobility

They are blind or visually impaired

They are D/deaf or hard of hearing

They identify as Neurodivergent

They have photosensitivity/light sensitivity

They experience seizures

They may make involuntary sounds or movements

They use a walking aid

They require a booster seat

They require ear defenders

They will be accompanied by an assistance dog

They would benefit from an audio enhancement headset (available at Elephant only)

They require the use of an Evac Chair in an emergency / They are unable to vacate the building independently in an emergency evacuation

They have other access needs (please specify):They have other access needs (please specify):

Tick as many boxes as are relevant

Do you or the person you are applying for require a personal assistant/essential companion? *

Yes

No

Is there anything else you’d like our team to know before your visit?

If you are human, leave this field blank.

You can update your access requirements directly in your box office account – click here to do this, log in, and then select “Other Preferences.”

You will still need to have an access membership on your account, which a member of the Southwark Playhouse team will issue to you upon receipt of this form.

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FirstName *

LastName *

Email *

If you are human, leave this field blank.

Box Office

020 7407 0234

boxoffice@southwarkplayhouse.co.uk

Opening Hours: Mon - Sat 10am - 6pm

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Copyright 2026 Southwark Playhouse Theatre Company Ltd.
Registered as a company limited by guarantee in England and Wales (no. 02994954).
Registered as a charity in England and Wales (no. 1042870).