'Ajax Clinic at Fortuna Wormerveer'

Fields with an * are mandatory

Personal details participant
First name of the participant
Middle name of the participant
Last name of the participant
The participants date of birth
The paticipants gender
Register another child and receive a 5% discount on the total amount
Address details
Street of the participant
City of the participant
Country of the participant
Contact details
Telephone number, for example: 0612345678 or 0201234567
Enter your email address a second time for confirmation
Participant details
Fill out 'none' if you're not registered at a football club.
The division your childs team plays in. The teams will be formed based on age and division of the childs team as good as possible.
Fill out 'none' if you're not registered at a football club.
Maximum age difference of 12 months. We cannot promise but we willl do our best!
Other details
Terms and conditions
s.v. Fortuna Wormerveer
Esdoornlaan 75
1521 EC Wormerveer
19 oktober 2021
Born in
2004 t/m 2015
Spots available