Book Learn to Row - Roeicentrum Berlagebrug

Personal information

Name*

Returning customer

I have a customer number

Address*

Email*

Customer number*

Your customer number has 6 numbers completed with a capital P. You can find yours on the invoice we have send you last time of ask the head coach.

Ploeggenoten

i would like to add teammates

Use this part of the form to subscribe teammates. This is a real subscription, so they don't need to subscribe themselfs. If you just want to let us know you want to row with someone you can mention that in the remarks box.

Phone*

Date of Birth*

Gender*

Team members (max 3)

First name	Last name	Customer number

Rowing course preferences

Course level*

Course periode*

We are allowed back on the water again. The summer course will be 7 lessons starting in the week from juli 13th

Preferred day*

Voorkeurstijd*

Preferred starting time*

Flexible*

Select All
Two hours earlier
One hour earlier
30 minutes earlier
30 minutes later
One hour later

Alternative day

Alternative starting time*

Remarks

Check out

How did you hear about us?

Friends
Facebook
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Other

discount code

Choice of payment*

If you still have a credit left because a cancelled course please select the invoice option.

Choice of payment*

If you still have a credit left because a cancelled course please select the invoice option.

Name of account holder*

IBAN bank account number*

Zaterdag Voorjaar 1 korting

0,00 €

maandag Voorjaar 1 korting

0,00 €

Zondag Voorjaar 1 korting

0,00 €

Zondag Voorjaar 2 korting

0,00 €

discount summer 7 lessons

0,00 €

Zondag Najaar 2 korting

0,00 €

Total

0,00 €

confirmation*

I do subscribe for the rowing course and i know i will be charged the according fees. I can cancel the subscription until 14 days before the course starts without costs.