Personal data
Surname*Prefix
Firstname*Initials *
Date of birth* * * *
Place of birthNationality
Country*
Zip code*House number *
StreetCity
Mail route
Telephone*Mobile
Email
[emailhelp]
*
Invoice email
Passport photo
Max. 8 MB. Dimensions min. 300 x 400 px. Different dimensions will be cropped to the middle of the picture.
Questions
Extra details
In case of emergency, telephone number
Duration of membership
If the duration of your membership is limited, enter the desired end date of your membership.
 
Ultimate history
Played at another club
Name previous club
 
Statutes, terms and conditions
*By ticking the attached checkbox you indicate that you have taken note of the statutes and the terms and conditions of Panic.
 
Personal data
Your data will not be shared with third parties for commercial use.
If this does happen, permission will be requested in advance.
However, if necessary, relevant data will be exchanged with third parties that are necessary for membership-related matters.
Agreement is required before entering into membership.
*I agree
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