Personal data
Surname *
Prefix
Firstname *
Initials *
Date of birth *
*
*
*
Place of birth
Nationality
*
Country *
Zip code *
House number *
Street
City
Telephone
Mobile
Email *
Invoice email
Passport-style photo (headshot)
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
Extra information
Phone number mother
Phone number father
Emergency contact
 
Lidmaatschapskeuze
Membership type
 
Accept automatic withdrawal
*Hierbij machtig ik The Elephants ESRC Eindhoven om doorlopende incasso-opdrachten naar mijn bank te sturen
om een bedrag van bovenstaand IBAN af te schrijven wegens de jaarlijkse contributie
en indien opgegeven andere verenigingsbijdragen.
Handtekening speler/ouder/verzorger*
Please fill in your name, this is considered a signature
 
Activity history
Did you play at a different club
Name previous club
Personal data
Your data will not be exchanged to third parties for commercial use. If this does happen, prior consent will be sought.
However, if necessary, relevant data will be exchanged with third parties needed for membership related matters.For entering into membership, agreement to this is mandatory.
*I agree
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