Become a member

You can complete the form below if you want to become a member of Maas en Roer. You also request a berth together with your membership. To do this, you provide the details of your boat.

Whether your request is approved depends on the availability of a suitable mooring and any waiting lists. you will receive further notice about this.

General

Last Name*

First name*

Prefix

Initilas*

Sex*

Salutation

Profession

Data of birth*

Name of your partner

Names and date of birth of children

Nationaliteit

Personal contact details

E-mail*

Mobile phone number

Fixed line phone number

Postal Adres

Street*

Number*

Extension

ZIP code*

Place*

Country*

Other

I agree to the privacy agreement

Date of agreement with privacy declaration

Membership

I agree with an automatic direct debit*

Banknummer 1*

BIC 1*

Berth

Boat brand

Boat type

Kind of boat

Naam boot

Boat length

Boat width

Boat draft

Boat weight

Year of construction

Electricity at berth

Voordat we een ligplaats kunnen toekennen, ontvangen we graag één of meerdere foto's van uw boot.

U kunt die per email versturen via onderstaande knop. Vergeet niet om dit formulier verder int te vullen en versturen.
Stuur een foto van de boot

Check*

Submit