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Register
portugalore
2023-11-26T15:40:13+01:00
Register
Step
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Team delegate details
Team
(Required)
Team leader
(Required)
Gender
Male
Female
Role
Contact
Email teamleader
(Required)
Enter Email
Confirm Email
Judge
(Required)
Gender
Male
Female
Role
Judge
Name
Gender
Male
Female
Role
Contact
Coach
Judge
Other
Name
Gender
Male
Female
Role
Contact
Coach
Judge
Other
Name
Gender
Male
Female
Role
Contact
Coach
Judge
Other
Name
Gender
Male
Female
Role
Contact
Coach
Judge
Other
Name
Gender
Male
Female
Role
Contact
Coach
Judge
Other
Invoice details
Please leave your details here for your invoice.
Billing name
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Blling Address
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Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
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Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
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Bouvet Island
Brazil
British Indian Ocean Territory
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Bulgaria
Burkina Faso
Burundi
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Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
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Croatia
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Cyprus
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Djibouti
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Eswatini
Ethiopia
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Gambia
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Germany
Ghana
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Panama
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Individual divers
Please note that only fully and correctly completed forms will be processed.
Date of birth is a required field.
Diver 1
Diver 1
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 2
Diver 2
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 3
Diver 3
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 4
Diver 4
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 5
Diver 5
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 6
Diver 6
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 7
Diver 7
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 8
Diver 8
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 9
Diver 9
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 10
Diver 10
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 11
Diver 11
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 12
Diver 12
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 13
Diver 13
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 14
Diver 14
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Diver 15
Diver 15
First name
Last name
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
1 m board
Junior star
A
B
C
All-in
3 m board
Junior star
A
B
C
All-in
Platform
A
B
C
All-in
Synchro couples
B/A and All-in
Synchro Diver 1
Gender
Male
Female
Synchro Diver 2
Gender
Male
Female
3 m board
B & A
All-inn
Synchro Diver 1
Gender
Male
Female
Synchro Diver 2
Gender
Male
Female
3 m board
B & A
All-inn
Synchro Diver 1
Gender
Male
Female
Synchro Diver 2
Gender
Male
Female
3 m board
B & A
All-inn
Synchro Diver 1
Gender
Male
Female
Synchro Diver 2
Gender
Male
Female
3 m board
B & A
All-inn
Synchro Diver 1
Gender
Male
Female
Synchro Diver 2
Gender
Male
Female
3 m board
B & A
All-inn
Team event
Juniors Mixed Team Event is composed of minimum 1 male and 1 female up to 4 (four) divers (mixed boys and girls of A and B Age groups (at least 1 from B present))
Team-event Diver 1
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
Team-event Diver 2
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
Team-event Diver 3
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
Team-event Diver 4
Gender
Male
Female
Date of birth
MM slash DD slash YYYY
Hospitality
Do you intent to use our hospitality services?
(Required)
Yes
No
Don't forget to fill in the hospitality form after you have send this registration form.
You said 'NO', are you sure? We will
not
arrange transport, lunch or dinner for you. You don’t need a discount code for Hotel van der Valk. If you do intent to use any of these, you have to choose ‘Yes’.
Responsibility coach * As a coach you are responsible for your team members and the divers.
(Required)
I agree with these
Terms and conditions
When sending us this registration form, you agree to the following terms and conditions.
Registration fee
All entrance fees will be paid in full at the latest on the 15th of January 2024.
Photo/video registration and publication policy
During the Eindhoven Diving Cup pictures and videos will be made. Visitors and participants of this event can reasonably expect that general photos and atmosphere photos and videos will be made in which they are visible.The Eindhoven Diving Cup and the media can use photos, footage and such, made during the competitions and the event for news, atmosphere pictures and promotional items of the event and the diving sport. It is not to be used for commercial advertising purposes. For that purpose permission must and always will be requested. It is forbidden to film and to take pictures in the changing rooms.
Consent
(Required)
With sending this form you are agree with our
privacy policy
Phone
This field is for validation purposes and should be left unchanged.
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