Membership WNA (per calendar year) event registration

Membership *

up to and including 17 years (€ 22.50)

18 years and older (€ 27.50)

Club membership ( €75,00)

First name *

Last name *

Date of birth

Address *

Postal code

City *

Country *

E-mail address *

Phone number *

Name club

Name parent / guardian / representatie *

Phone number parent / guardian / representatie *

*

Parent / Guardian / Representative declares to agree with the above and has entered the personal details below truthfully.

Comment

Amount

€

Payment Method

Mollie | PayPal / Ideal / Bancontact

Billing Zipcode*

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Type*

Card Holder Name*

By registering, I accept Terms and Conditions

Registration