View this form in Dutch?* Required

Are you already Rabarber participant*
  
How did you find us
  
First choice group*
  
Second choice group
  
Comment on group selection
  
First name*
  
Infix
  
Last Name*
  
Gender*
  
Date of birth*
  
Address (street, number and addition)*
  
Postal Code*
  
City*
  
Home Telephone Number*
  
Parent/guardian Mobile Number 1*
  
Parent/guardian Mobile Number 2
  
Mobile Number participant
  
E-mail Parent (Billing Address)*
  
E-mail participant
  
(Medical) notes
  
School
  
Hobbies
  
Ooievaarspas 
  
Ik wil graag vriend worden van Rabarber met (Minimaal € 25,-) 
I would like to receive the Rabarber newsletter  
* I agree with the processing of my data according to thePrivacy statement  
Mandate for recurrent collections 
IBAN number*
  
Name account holder*
  
* I accept the terms and conditions
 
  
Instructions for the registration
Useful links

Registration
Registrations can only be processed if all the required information (*) is entered.

Payment
Payment of tuition is only possible by direct debit.

Cancellation
Cancellation is only possible in writing (e-mail or letter). For more information, see the General (payment) conditions.