SIGN IN Male or female (verplicht) Male Female Date of birth (verplicht) Nationality (verplicht) Full name (Firstname + Lastname)(verplicht) E-mail(verplicht) Phone number (verplicht) Adress (Street + Postal Code) (verplicht) Housenumber(verplicht) City (verplicht) Private or Company (verplicht) Private Company: Fill in (if via Company) Membership(verplicht) 6 MONTHS BASIC PACKAGE: SLEEP + SPORTS W/ EQUIPMENT (€350 excl. VAT per month) 6 MONTHS NUTRITION PACKAGE: SLEEP + SPORTS W/ EQUIPMENT + NUTRITION (€450 excl. VAT per month) 12 MONTHS SLEEP ONLY (€100 excl. VAT per month) 12 MONTHS SPORTS ONLY NO EQUIPMENTS (€150 excl. VAT per month) 12 MONTHS SPORTS UNLIMITED W/ EQUIPMENT (€300 excl. VAT per month) 12 MONTHS BASIC PACKAGE: SLEEP + SPORTS W/ EQUIPMENT (€299 excl. VAT per month) 12 MONTHS NUTRITION PACKAGE: SLEEP + SPORTS W/ EQUIPMENT + NUTRITION (€399 excl. VAT per month) Payment: (verplicht) Invoice Deposit to bankaccount – By filling in this form, you give us permission for sending you a mail. – I agree that I have read this contract carefully. – As a member, I agree to comply with the terms and conditions of membership; theseconditions are handed to me together with this form on http://www.jbpersonalcoaching.com. JB Personal Coaching may make reasonable changes to these rules at any time provided it gives advanced notice of these changes. – As a member, I agree to comply with the terms and conditions of the ‘Privacy beleid’ and the ‘Algemene voorwaarden’; these conditions are handed to me together with this form on http://www.jbpersonalcoaching.com. JB Personal Coaching may make reasonable changes to these rules at any time provided it gives advanced notice of these changes. I agree: (verplicht) I agree that I have read this contract carefully. Date of today: SIGN IN Δ
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