Subscribe – Tilburgse Studenten Alpen Club

By filling in this form I declare that I would like to become a member of TilSAC.
This subscription form will be processed after the membership fee has been paid: Membership fee is € 22,- for a (academic) year. From February 1st onward we offer half year memberships. The half year membership fee is € 12 euro,- and lasts until the end of the academic jaar.

First name *

Last name *

Street name + number *

Zipcode *

City *

Mail address *

Date of birth *

Mobile number *

Bank account (IBAN) *

Emergency number *

Educational institute

Student number

NKBV membership nummer

Customer number Sports Center (Important, this will be used for subsidy at the Sports Center)

I declare that TilSAC can use my customer number from the Sports Center

House rules (https://tilsac.nl/huishoudelijk-reglement/) and Privacy (https://tilsac.nl/privacybeleid/) * I hereby declare by means of my signature that I have taken knowledge of and agree with the terms and conditions of TilSAC *

I authorize TilSAC to continuously debit the yearly contribution (established by the ALV) from the bank (IBAN) account mentioned above *

In addition, I declare that if I participate in TilSAC activities, it will be at my own risk. Also, I declare that I have arranged a valid insurance for any risks or harm during climbing which will cover my own risks, but also cover any accident caused by myself (material, physical or mental damage). Finally, I can in no way hold the association or the board members accountable or make claims regarding any injury, damage and loss occurred during any TilSAC related events. *

Contribution *

Contributie Volledig Academisch Jaar 2023 - 2024 (€ 22,00)
Contributie Semester 1 Academisch Jaar 2023 - 2024 (€ 12,00)

Payment method *

iDEAL (+ € 0.29)
Overboeking (+ € 0.45)

Total

€

	October 2023
Mon	Tue	Wed	Thu	Fri	Sat	Sun
						1
2	3	4	5	6	7	8
9	10	11	12	13	14	15
16	17	18	19	20	21	22
23	24	25	26	27	28	29
30	31