Internet Zwemscore Module

First name*

Surname prefix

Last name*

Date of birth*

Gender*

Male Female

Street*

House number*

Zip code*

City*

Phone number*

Mobile

Name of account holder*

IBAN*

BIC

Email address*

Controle e-mailadres*

Start in (preference) *

Sign up for*

Group conditions

Availability

Comment

Payment method

We collect €3 registration fee (One-time Payment).

The lessons are paid through iDeal at the end of every month, based on how many lessons you participated in.

iDeal

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