Personal data
Surname *
Prefix
Firstname *
Initials *
Date of birth *
*
*
Country *
Postal code *
Number *
Street
City
Telephone
Mobile *
Email *
Photo
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
Below we request more information about the desired membership type *
Id like to become a full member (senior, young senior, junior)
Id like to become a day member (senior)
Id like to become a non-playing member (senior)
 
What is your KNLTB number (if known)
What is your playing strength in singles (if known)
What is your playing strength in doubles (if known)
 
Authorization for payment by direct debit
* I hereby authorize ALTC DDV to debit the annual club fee and if specified, other club payments by direct debit from the above IBAN number.
If a member is younger than 18, his / her parent / guardian declares that he / she agrees with the above authorization.
Signature Player / parent / caregiver *
Please enter your name, it will be considered as a signature.
 
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