Clingendael Run&Walk

Because you want your whole life to be fit!

  
  

By filling out this online registration form I become a member of Clingendael Run&Walk and authorise Clingendael Run&Walk for Direct Debit. The first month of training sessions are completely free, this is the trial period. If you decide to cancel the membership during this trial period then this can be done free of cost. The fee is €10 per month, the first Direct Debit will be one month after attending the first training. You will also be registered at the ‘Atletiek Unie’ , the annual fee that the club pays will be debited at the beginning of the year (the fee for 2018 is €16,95). Your personal information will be held by the club and may be passed to Dutch Athletics Union for purposes of runner registration, but will not be passed to any other third parties or other members without prior permission. I declare that in joining Clingendael Run&Walk I agree to this privacy policy and I agree to abide by the rules of the club, as stated in the current Constitution and Rules.


Step 1: Membership registration
First Name (*) x
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Last Name (*) x
Street (*) x
House/building number (*) x
Addition Invalid Input
Postcode (*) x
Town/City (*) x
Email address (*) x
Date of birth (*)
x
x
x
Gender (*) x
Telephone (*) Ongeldig telefoonnummerex. 070-7654321
Emergency telephone Onjuist telefoonnummerex. 06-87654321
My condition is (*) Please make a choice
Reason for membership (*) Please make a choice
How did you hear about us? (*) Please make a choice
Please confirm

Comments:
Please indicate hear the date you want to attend your first training.
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Step 2: Authorisation fro Direct Debit
Holder's bank account information:
Name (*) x
Address (*) x
Postcode (*) x
Town/City (*) x
IBAN Bank account (*) x
Enter a IBAN bank account number

Hereby I authorise Clingendael Run&Walk, The Hague with ING bank account number NL93 INGB 0000 9283 82
1. to debit my bank account once with the registration fee of 15 euro of my bank account
2. to direct debat my bank account with the annual fee for the Atletiek Unie (€16,95 in 2018, anually indexated)
3. to direct debit my bank account with 10 euro per month until I cancel my membership. The payment reason is: Contribution Clingendael Run&Walk. The first direct debit will occur 1 month after attending the first training, consecutive at the start of each month.

Step 3: Confirm
After submitting this form you will receive a confirmation email. Please print this email and sign the authorisation and bring it with you on your first training. Without completely filled out and signed registration form we will not allow you to attend a training session.

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After submitting you'll receive a confirmation email

Info....

  1. Name(*)
    Please let us know your name.
  2. Email address(*)
    Please let us know your email address.
  3. Your question:
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