Registration Membership

Calling name

Official given names

Surname prefix


Place of birth

Date of birth (YYYY-MM-DD)



Postal code


Telephone number

Email address

Number U-pas or students card

Expiration date U-pas of students card (YYYY-MM-DD)

Registration date (first training after trial month YYYY-MM-DD)

By submitting this form, the above person applies for membership of Sanshinkai Aikido Utrecht and after being admitted accepts the rights and obligations as formulated by statuary law and rules and regulations. He or she also states to be physically and mentally healthy enough to practise aikido, to abide the house rules and be at least 14 years of age.

Name guardian, when under age of 18

Telephone number guardian, when under age of 18

Email address guardian, when under age of 18

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