Registration form Amsterdam Crusaders ENGLISH

Completion date*

Name*

First name Last name

Important to know: Your name and address details can be checked by us while attending the training. (Always bring your ID, or from the parent or guardian).

Initials*

Date of birth*

Sex*

Nationality*

Address*

Street + number Postal code City Country

Phone number*

Enter your telephone number where you can be reached here

E-mail address*

Email Confirm Email

Fill in your E-mail address here

Health insurer*

Enter the name of your health insurer here

Health insurance card number*

We ask you to fill in your health insurance card number, so that we can pass it on to the care provider in the event of an emergency.

Name and Telephone number of contact person in case of emergency*

Enter the name and telephone number of your contact person in case of Calamities (accident, etc.).

Please indicate any allergies and / or physical limitations if you have them

Your age*

18 years or older
18 years or younger

Details of parents / guardian. (If new member is younger than 18 at registration).

Details of parents / guardian*

Street + number Postal code City Country

Fill in this information if the new member is younger than 18 years old

Telephone number PARENT / GUARDIAN*

E-mail address PARENT / GUARDIAN*

E-mail Confirm

Recent passport photo for your player pass*

Toegestane bestandstypen: jpg, Max. bestandsgrootte: 2 MB.

Upload your passport photo here that will be used for your player pass and any placement on the Amsterdam Crusaders website

Discipline choice*

Please select your team choice, the final classification is determined by the Coaches

ATTENTION !: Each member can be assigned to fulfill tasks for the club. Parents of youth members are involved in the transport to and from away matches CONTRIBUTION AND MEMBERSHIP DURATION: The contribution is paid in advance per YEAR and must be received in full or in several installments before March 1. The membership fee can only be paid by means of an authorization. The authorization will be executed at the end of November. Membership is entered into for one season (Jan 1 to Dec 31). If not canceled in writing before November 1, the membership will automatically be extended by one season and a membership fee is due. In case of interim registration, the collection starts the following month. Contribution Flag; Peewees, Cubs and Seniors € 190.00 / Tackle; Peewees, Cubs, Cadets and Juniors € 250.00 Senior Tackle € 360.00 It is mandatory to purchase competition pants. This can be done in the Crusaders webshop These amounts apply to regular competition. The contribution can be paid in installments. An administration fee of € 5.00 is charged for each installment. / Donor from € 60.00 per year. Friendly and IFAF matches may incur additional charges.

I choose payment. (make your choice)*

In 1x (at the end of November prior to the season, membership fee and € 5.00 administration costs, or at registration during the current membership year) In ………… ** installments (2, 3 or 4), whereby € 5.00 administration costs are charged per installment

In 1 time (end of November prior to the season, membership fee and € 5.00 administration costs, or when registering during the current membership year)
In 2 installments, whereby € 5.00 administration costs are charged per installment
In 3 installments, whereby € 5.00 administration costs are charged per installment
In 4 installments, whereby € 5.00 administration costs are charged per installment

Name of account holder*

IBAN number*

Permission for direct debit*

Automatic collection
Your registration also serves as confirmation of an authorization issued to Amsterdam Crusaders in writing. With this authorization you give permission to Amsterdam Crusaders to send recurring direct debit orders to your bank, to debit an amount from your account for contributions and other periodic amounts and your bank to continuously debit an amount from your account in accordance with the order van Amsterdam Crusaders, Creditor ID: NL76ZZZ405344460000 If you do not agree with the debit, you can have it reversed. Please contact your bank within eight weeks of the debit. Ask your bank for the conditions.
Important: we request that you also use the bank account specified for the direct debits to make the payment for the first Deposit registration / contribution via this website.

I agree to automatic collection of the contribution

Permission to use personal data for membership administration, communication and AFBN*

Name of parent / guardian / guardian

PAY ATTENTION ! For members younger than 18 years, a parent / carer / guardian must agree.

Consent statement processing personal data
As Amsterdam Crusaders we are responsible for the processing of your personal data. That is why we want your permission for this if you want to be registered as a member. If you are younger than 18, the declaration of consent must be given by one of your parents, carers or guardian.
I agree with the privacy policy and processing personal data.

You can read our Privacy Policy here

The last step, if you click on SEND you will automatically go to the webshop to make a deposit of € 75.00 as a deposit on registration fee and membership fee.

Comments
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