Waiver Mitglieder

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Status

Mitglied Gast

Vorname

Name

Geburtstag

Straße

Hausnummer

PLZ

Ort

E-Mail

Handynummer

Notfallkontakt

Handynummer Notfallkontakt

Exit Gewicht in Kg

Lizenzart

Lizenznummer

Versicherung bis

Berechtigung

AFF Lehrer Tandemmaster

Sprünge gesamt

Equipment

Schirmgröße

Prüfung der Reserve bis

IBAN

Bank

Skydive Altenstadt - Enthaftungs

Enthaftungserklärung:

Hiermit versichere ich, dass ich die Enthaftungserklärung gelesen habe

SEPA Mandat erteilt

Hiermit erteile ich das SEPA Lastschriftmandat

Datum

Unterschrift: