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*

Preferred day*

Voorkeurstijd*

Preferred starting time*

Flexible*

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

Alternative day

Alternative starting time*

Remarks

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discount code

Algemene Voorwaarden*

Ik ga akkoord met de algemene voorwaarden

Total

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