Registration form BJJ Rotterdam BJJ Rotterdam registration form First name * Last name * Gender * M V Date of Birth * E-mail address * Phone number * Address * Zipcode * e.g. 1234AA City * Date of registration * Membership * Single lesson: €15,- 10-lessons card: €100,- (€10,00 per lesson) Membership "1 x per week": €35,- p/m (€8,75 per lesson) Membership "unlimited": €50,- p/m (€4,17 per lesson) Bankaccount number (IBAN) * Ascription * I am 18 years or older For registration and direct debit authorization you must be 18 years or older or have permission from a parent/guardian. First name parent/guardian * Last name parent/guardian * E-mail address parent/guardian * Phone number parent/guardian * I hereby authorize BJJ Rotterdam to collect the monthly contribution by direct debit. * I agree with the Terms and Conditions * I give permission to use my e-mail address for news items about BJJ Rotterdam. I give permission to share photos and videos I'm on externally via WhatsApp / internet. (Website, YouTube, Facebook, Instagram) * One-time registration fee BJJ Rotterdam has a one-time €15 registration fee. New members receive an embroidered logo patch from BJJ Rotterdam. Privacy This data is only stored and used to contact you regarding membership at BJJ Rotterdam. This data is not shared with third parties or used for commercial purposes without permission. Note! Our response to your submission may end up in the spam box of Gmail and Hotmail accounts. So keep an eye on this folder as well! (Should it be in this spam box, you would help us a lot by marking our mail as "safe"). reCAPTCHA Indien je een mens bent, laat dit veld leeg:. Send Δ