Way to order: Please fill out all the fields marked with *. We will send you an invoice, upon payment we will send you your membercard.

E-mail address*

First name*

Second name

Last name*

Address*

Postal code*

City*

Country*

Handicap*

Date of birth*:

** Please transfer the amount to:
Bank: ABNAMRO - Breda
Rekening: 48.62.95.907
IBAN: NL48 ABNA 0486 2959 07
BIC: ABNANL2A

Bedankt voor het bestellen van de membercard. Na betaling van onze factuur, die we u per omgaande zullen sturen, ontvangt u de membercard.