Personal data
Surname *
Prefix
Firstname *
Initials *
Date of birth *
*
*
*
Place of birth
Nationality
*
Country *
Zip code *
House number *
Street
City
Telephone
Mobile *
[emailhelp]
Email *
Invoice email
"profile picture (picture as on your passport)"
Max. 8 MB. Dimensions min. 300 x 400 px. Different dimensions will be cropped to the middle of the picture.
IBAN nr.
Name account holder
Questions
Additional information
Phone number in case of emergency
What are your preferred pronouns?
 
Membership
I'm signing up for:
If you wish to register for a regular membership, please use a different form, found here: regular registration form
I am a student (only applicable for Senior memberships)
In case you are a student, please send a picture of your student card to ledenadministratie@arcrugby.nl
 
Agreement automatic payment
*I hereby authorize the Amstelveense Rugby Club to send standing orders to my bank
to debit an amount from the above IBAN for the annual membership fee
and, if specified, other association contributions.
Please be aware that for participation in the Intro Course, we will send you an invoice (€50) with an iDeal link.
Please settle this invoice at your earliest convenience, as it is compulsory to pay this before you are allowed to participate.
We hope you like the course so much, that you want to become a member. For the regular membership fees, we ask
new members for direct debit payment agreement. This will only come in place after you have indicated you want to become a member
 
Instalments
For the regular membership (not the introcourse), we offer the possibility to pay the membership fee in instalments
When registering for a new season, these will be debited in five equal instalments in August, September, October, November and December.
When registering during the season in consultation with the treasurer.
For payment in instalments, an administration fee of EUR 5 is charged.
I would like to pay the contribution in instalments.
 
Previous experience
Have you played at another rugby club?
Name previous rugby club:
 
Knowledge of bylaws (statuten) and household regulations
*By checking the attached checkbox you indicate that you have taken note of the bylaws and household regulations of Amstelveense Rugby Club
 
Personal details
Your data will not be shared with third parties for commercial use.
However, if necessary, only relevant data will be exchanged with third parties for membership-related matters.
Agreement is required before entering into membership.
*I agree
 
Signature
I hereby declare that the information provided is true and correct.
Signature player/parent/guardian*
Please enter your name, it will be considered as a signature
Comment