REGISTRATIONFORM
AND MANDATE RECURRENT PAYMENT
JEUGD
v.v. Wilhelmus
Groene Zoom 2, Den Haag
Postbus 571
2270 AN Voorburg
tel. 070-3866595
www.vvwilhelmus.nl
Mail this form (2 pages) to: [email protected] or
Send it to: v.v. Wilhelmus, Postbus 571, 2270 AN Voorburg
Family Name
First Name
Initials :
Place of birth
Date of Birth:
Boy
Girl
Nationality :
Adress
ZIP code
Place of Residence
Home Phone
Mobile Phone
E-mail
Identification parent/caregiver
Passport
Driving Licence
ID-card No.:
1. Please attach a copy of identification of the parent/caregiver
2. When year of birth is 2003 or before ad an original passport photo (no scan) for the KNVB player card
Type of membership 2014-2015: please select one
A-youth 1996/1997
€ 193,- per year
€ 96,50 per half year
B-youth 1998/1999
€ 182,- per year
€ 91,00 per half year
C-youth 2000/2001
€ 172,- per year
€ 86,00 per half year
D-youth 2002/2003
€ 162,- per year
€ 81,00 per half year
E-youth 2004/2005
€ 152,- per year
€ 76,00 per half year
F/MP-youth 2006 en younger
€ 142,- per year
€ 71,00 per half year
A € 25,- administration fee is charged. This is a one off fee per registration form.
Payment of the Membership Fee is done yearly or half-yearly by direct debit. Any other form of
payment, e.g. cash or transfer, will have an additional charge of € 10,=.
Administration fee after a yellow or red card, which are charged by the KNVB to vv Wilhelmus, will be
charged to the player by direct debit within a month.
Have you been a member at a different football club in the past three years?
No
Yes, I was a member at................... from ../../.. until ../../..
Please attach a form of transfer from your previous club.
.
REGISTRATIONFORM
AND MANDATE RECURRENT PAYMENT
JEUGD
v.v. Wilhelmus
Groene Zoom 2, Den Haag
Postbus 571
2270 AN Voorburg
tel. 070-3866595
www.vvwilhelmus.nl
We run the club together!
Would you like to help with the organisation of the club and volunteer?
Every non-profit organisation needs volunteers. We therefore ask all vv Wilhelmus members if they are able
to contribute as volunteers. vv Wilhelmus tries to divide the various tasks in order to keep all aspects of the
club running smoothly throughout the season. For example, the club opens its canteen during practice
evenings and matches, it also organises tournaments.
In what way are you able to help the club by volunteering some of your time?
canteen
sponsorship
tournaments
social activities
accommodation (during tournaments, etc.)
youth section
MANDATE RECURREND PAYMENT
Name creditor
v.v. Wilhelmus
Adress creditor
Groene Zoom 2
ZIP code/ place of residence
2491 EH Den Haag
Country creditor
Nederland
Creditor Identifier
NL56ZZZ271593500000
Mandate reference
BBGW82B+lidnummer (see first payment)
Please write your name, IBAN bank account here below and sign the form to authorise vv Wihelmus to
directly withdraw the Membership Fee from your account. A signed form authorises your payment by direct
debit, this is an automatic withdrawal from your bank account. Please note that besides a Dutch bank
account also numbers from most European countries can be used.
When you don’t agree with a payment you can have it refunded. Contact your bank within eight weeks after
withdrawal.
Name and initials
Adress
ZIP code/residence
Country
IBAN/BIC
Place / date
Signature: