Form Skiff Hassle - 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.

Phone*

Date of Birth*

Gender*

Rowing course preferences

Hassle skiff cursus

Make your choice in Hassle Skiff Course
- Beginner, previous experience in Liteboat single scull or similar (C1)
- Advanced, experience in the (Hassle) single scull

Course periode*

Cursus periode*

Preferred day*

Voorkeurstijd ochtend*

9:15
10:15
11:15
12:15

Preferred starting time*

17:15
18:15

Voorkeurstijd avond*

17:15
18:15

Voorkeurstijd avond*

17:15
18:15

Voorkeurstijd avond*

17:15
18:15

Voorkeurstijd avond*

17:15
18:15
19:15
20:15

Voorkeurstijd avond*

17:15
18:15
19:15
20:15

Voorkeurstijd avond*

17:15
18:15
19:15
20:15

Voorkeurstijd avond*

17:15
18:15
19:15
20:15

Flexible*

Select All
One hour earlier
One hour later

Alternative day*

If ypur starting time is different on the alternative day please mention it in the remarks.

Remarks

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How did you hear about us?

I already row with TopRow
Friends
Facebook
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Google
Other

Choice of payment*

Name of account holder*

IBAN bank account number*

Total

0,00 €

Skiffcursus Hassle

Personal information

Rowing course preferences

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