Inschrijfformulier lidmaatschap 2026 | Speeltuin de Torteltuin

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Inschrijfformulier lidmaatschap Speeltuin de Torteltuin voor het jaar 2026

Contributie

o Ouder(s)/Verzorger(s) met 1 kind € 30,00

o Ouder(s)/Verzorger(s) met 2 kinderen € 35,00

o Ouder(s)/Verzorger(s) met 3 kinderen € 40,00

o Ouder(s)/Verzorger(s) met 4 of meer kinderen € 45,00

o Extra abonnement voor een volwassene/au pair € 17,50

o Een bijdrage voor instandhouding van Speeltuin de Torteltuin is welkom. Deze gift kan bij betaling worden meegenomen of extra gestort bij betaling via de bank. Gift voor instandhouding Speeltuin de Torteltuin: € …………………………..

Naam : ………………………………………………………………………………………………. Adres : …………………………………………………………………………………………………. Postcode : ……………………………….. Woonplaats: ……………………………………… Telefoon : ………………………………… Telefoon achterwacht: …..………………………… E-mailadres : ………………………………………………………………………………………………………… Gezinsleden Tweede Ouder/Verzorger: ………………………………………………………………………………..

1e Kind: ………………………………………….. geboortedatum: ………………… J / M

2e Kind: ………………………………………….. geboortedatum: ………………… J / M

3e Kind: ………………………………………….. geboortedatum: ………………… J / M

4e Kind: ………………………………………….. geboortedatum: ………………… J / M

5e Kind: ………………………………………….. geboortedatum: ………………… J / M

Contributie kan per kas betaald worden of worden gestort op bankrekening NL95 ABNA 0830 1016 67 t.n.v. Speeltuin de Torteltuin te Rotterdam.

Om administratieve en kostenbesparende redenen is betaling per kwartaal of halfjaar niet mogelijk. Bij start van het lidmaatschap vindt geen verrekening plaats voor de verstreken termijn.

Beëindiging van het lidmaatschap dient voor 1 december van het lopende jaar schriftelijk of per e-mail in te dienen bij het secretariaat (secretariaat@detorteltuin-rotterdam.nl)

Dit formulier inleveren bij de speeltuin op de Van Enckevoirtlaan 6, 3052 KR Rotterdam. Door ondertekening verklaar ik akkoord te gaan met bovenstaande voorwaarden.

Rotterdam, datum …. / ….. / 2026

Handtekening aanvrager: