Register as member of Hydrofiel

With this form you register as a member for Hydrofiel. Your registration is verified and accepted by the board, afterwards you get access to the website. You'll also get an email to confirm your emailadress. We do this to make sure that we can reach you via the provided emailadress.

Personal details

Name Prefix Lastname Sex Birthday

I prefer English

Contact details

Streetname Housenumber Postalcode City Email Phonenumber

Contact details in case of emergency

Relation (mother, brother, housemate, ...) Phonenumber

Bank details

In the name of Bankaccount number BIC

Study details

Education Studentnumber

Membership details

Membership Sportcardnumber

T-shirt

I want to buy an original Hydrofiel t-shirt, this costs between 5 and 10 euros (price varies per year). I accept that N.S.Z.&W.V. Hydrofiel will deduct the money automatically from my bankaccount.

Conditions

I authorize N.S.Z.&W.V. Hydrofiel to deduct the membership fee and the (possible) compensation for the work activity from my account once a year (2 terms for waterpolo - competitive). Furthermore I authorize N.S.Z.&W.V. Hydrofiel to debit the costs of activities, in which I participated, from my account.