Ontdek de e-bike - Accept invitation

Welcome to the registration page of 'Ontdek de e-bike' for private individuals.

Do you normally use a car to commute and do you live or work in Maastricht ? Then you qualify to try the e-bike for a week. You have to pick it up at our Distribution point Cycle Center, De Leeuwhof 21, 6301KZ Valkenburg.

Are you interested and do you qualify? Enter your information below to create an account to book and ride an e-bike.

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Profile

First name *

Last name *

Sex *

Date of birth *

Address

Country *

Zip code, address *

Address *

Place *

Contact

Phone number (Work) *

Mobile. *

Account

Business (or private) email *

Password *

Password (confirmation) *

Employer

Employer name

Enter your employer below. If you don't have an employer, fill in 'Actie Ontdek de e-bike'.

Employer phone number

Zip code, address

Address *

Place *

Travel profile

Indicate how you commute in an average week, e.g. what your main transportation is (the vehicle you use for the most distance).

How many days a week do you travel to work on average?

Commuting distance (one way, in kilometers) *

Means of transport*

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I accept the Terms and conditions *