Swimming in Veldhoven

V.Z.V. Njord

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Registration form new members

    I registrate for:

    Leszwemmen op:TuesdayWednesdaySaturday,   zwemdiploma:neeja:ABCswimming skills

    Swimming workout

    Underwater hockey:with logbook numberwithout logbook numberwith First Aid knowledgeno First Aid knowledge

    Water polo:swim polo or inflowcompetition

    Competition swimming:with start numberwithout start number

    Personal details

    Family name*

    Given name*

    Initials*

    Day of birth (dd-mm-yyyy)*

    Gender*
    MaleFemale

    Address*

    Postal code*

    City*

    Phone number*

    E-mail address*

    Remarks

    Agreement

    I agree that Njord can use my details for internal communication during my membership.

    *Required fields