Registration Form

---

You are just 3 minutes away from making a whole squad of new friends. Fill in the form below, and we will arrange your KNVB profile, which makes you eligible to battle with your future friends in official football matches!

New Member Registration

Name *

Name

First

First

Last

Last

Initials *

Email *

Please use your private e-mail address, not your wur-mail 🙂

Gender * FemaleMaleNon-binaryOther

Nationality *

Type of membership *

Match membership student (full-season)Match membership student (half-season)Match/training PhD/graduate membership (full-season)Match/training PhD/graduate membership (half-season)Training only membership student (full-season)Training only membership student (half-season)

Please note: match membership includes training

Do you have any previous football experience and if so, how much? *

WBA number

You get this number by removing the first 4 numbers and the last 2 numbers from the barcode on your WUR card. If the remaining number starts with one or more zeros, you can also remove these.

Phone number (please include your country prefix, if non-Dutch) *

Date of birth (dd/mm/yy) *

Address (If possible, please give your Dutch address) *

Postal code *

City *

IBAN (bank account number) *

Bank Identifier Code (BIC)

Not compulsory to fill in when in possession of a Dutch IBAN

The membership fee will be collected around the 1st of November. *

I hereby authorize GVC for recurrent direct debit collection

If you only play the second part of the season, this will be the 1st of March.

Privacy Statement *

By checking this box you indicate you are aware of the privacy statement and your rights when it comes to personal details.

Sports Rights *

By checking this box you indicate that you will have the required sports rights provided through De Bongerd

Please note that you need to have a WUR card with sports rights to join our association. If you are not is possesion of sports rights, and GVC gets a fine, you will have to pay for it.

Any additional comments?

If you are human, leave this field blank.

Submit

Δ

---