Membership

Ultra Rare Sarcoma e. V.

I hereby apply for membership in the association. Ultra Rare Sarcoma e. V. and recognize the Statutes as well as the Membership Fee Regulations in their currently valid version.

Membership type

Individual membership €30/year (adult aged 18 and over)

Individual membership €30/year (child/young person under 18 years)

Supporting member (no voting rights, no active participation in the association)

Membership fee (only for supporting members)

50€

100€

Own amount

Amount

title

First name

Last name

Gender

Birthday

Personal Information:

Street

House number

Postal code

City

country

Telephone number

e-mail

Name of parent/guardian

In the case of minor applicants

I am the legal guardian and hereby give my binding consent to my child's membership application. I acknowledge the statutes and fee regulations of the Ultra Rare Sarcoma e.V. association. I assume the obligation to pay my child's membership fees and am liable, within the framework of the statutory provisions, for any obligations arising from my child's membership.

I myself have a sarcoma and would like to voluntarily provide information about my illness.

Yes

diagnosis

Consent to the processing of health data *

I have the Consent to the processing of health data (Art. 9 GDPR) I have read and expressly agree. Providing this information is voluntary and has no bearing on my membership.

I am the legal guardian of the above-mentioned child and expressly consent to the processing of their information regarding their illness by the association Ultra Rare Sarcoma e.V. within the scope of the association's work. I have the Consent to the processing of health data (Art. 9 GDPR) read.

Consent to networking

I voluntarily consent to the association putting me in contact with other affected individuals. I can revoke this consent at any time.

I am the legal guardian of the child named above and voluntarily consent to the association bringing my child into contact with other affected individuals. I can revoke this consent at any time.

Data Privacy Consent Form (GDPR)*

I consent to my personal data being stored and processed by the association Ultra Rare Sarcoma e.V. exclusively for association purposes in accordance with the GDPR. Privacy Policy

I am the legal guardian of the above-mentioned child and consent to the storage and processing of their personal data by the association Ultra Rare Sarcoma e.V. exclusively for association purposes in accordance with the GDPR. Privacy Policy G.

The account holder is identical to the member.

Yes

First name

Last name

Street

House number

Postal code

City

country

IBAN

BIC

Credit institution

Member details (if different from account holder):

SEPA Direct Debit Mandate

I authorize the association Ultra Rare Sarcoma e. V. to collect payments from my account by direct debit on the specified due date.
At the same time, I instruct my credit institution to honor the direct debits drawn on my account by the association.

A notice: I can request a refund of the debited amount within eight weeks, starting from the debit date. The terms and conditions agreed upon with my bank apply.

Payee:
Ultra Rare Sarcoma e. V.
Theresienstraße 71D
80333 Munich
Creditor Identifier (CI): DE35ZZZ00002826792

Consent to SEPA authorization

I expressly agree to the above SEPA direct debit mandate and consent to the debiting from the specified account.

A notice:

This consent becomes legally binding upon submission of the form. Your IP address and the timestamp will be stored for legally compliant documentation.

The membership application will only become effective after review by the board. Membership begins upon receipt of written confirmation via email.

Application Supporting membership

Ultra Rare Sarcoma e. V.

Application
Supporting membership