Entry Form

Membership

Are you interested in becoming a member of the Eindhoven lifesaving club (for swimming lessons or lifesaving education), you can fill out the digital entry form on this page. By sending it after completion of the form, it will reach our membership administration. We will reply to you by email to make the entry final. Finalising means being prepared to pay the monthly memberships fee (see rates) by automatic bank transfer. As soon as the permit for bank transfer is completed, you will receive an email confirming when and where to start at our club

If you have further questions, please contact our membership administration:
[email protected]

* Indicates required field

Initials *

First Name *

Insection *

Family Name *

Street *

House Number *

Addition to the house number *

Postal Code *

Town *

Date of birth

Year *

Month *

Day *

Place of Birth *

Man / Woman / X *

Man Woman X

E-mail adress *

Phone Number *

Pool of preferance or course *

Remarks and Questions *

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Entry Form

Membership

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