Inschrijven bij LHBTI-sportclub Kouros Eindhoven

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1
Welke sport? (Which sport?)
Start datum (Starting date)wanneer wil je het lidmaatschap in laten gaan? (When do you want to start your membership?)
Voornaam(First name)
Achternaam (Last name)
Straat (Street)
Huisnr. (House nr.)
Postcode (Zip code)
Woonplaats (Residence)
Telefoon (Phone)
Email
Geboortedatum (Date of birth)

Je blijft lid tot wederopzegging. Alleen voor Stijldansen meld je je aan per seizoen. Opzeggen kan via email. Kouros werkt met vrijwilligers, daarom maakt Kouros gebruik van automatische incasso. Ik machtig hierbij Kouros om de verschuldigde bedragen automatisch van mijn rekening af te schrijven.


You remain member until you unsubscribe. Only for Ballroom dancing you subscribe per season.  

Unscribing is possible by email. Kouros is run by volunteers, that is the reason for automatic collection of you membership fee. I hereby authorize kouros to automatically debit the amounts due from my bank account  

Rekening nummer (Bank account) IBAN
Rekening houder (Account holder)
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