Customer number (if available)

First name

Family name (Surname)

E-mail Address

Phone

Mailing address

Desired category Desired category *Category 1 | 85,- EURCategory 2 | 79,- EURCategory 3 | 69,- EURCategory 4 | 60,- EURCategory 5 | 54,- EURCategory 6 | 51,- EURCategory 7 | 44,- EUR

Amount Amount *1 subscription2 subscriptions3 subscriptions4 subscriptions5 subscriptions6 subscriptions

If not available, I would accept: If not available, I would accept: any other category the next higher category the next lower category no other category

I apply for the following membership and receive 2 subscriptions 10% cheaper: I apply for the following membership and receive 2 subscriptions 10% cheaper: Ordinary membership (€ 90,-) Youth membership up to 30 years (€ 15,-) Supporter (€ 500,-)

Date of birth

Additional remarks (e.g. I require a wheelchair space)

May we inform you about offers by e-mail? May we inform you about offers by e-mail? Yes, with pleasure. No, I'd rather not.

Terms and Conditions Terms and Conditions Agree. Read terms and conditions.