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

Check*

Submit