Doneren aan de Antwerp Pride

Name *

Email *

Which kind of payment is this? *
Donation (€ 5,00) (€ 10,00) (€ 20,00) (€ 25,00) (€ 50,00) (€ 100,00)

Amount *
€

Payment method *
Credit card PayPal iDEAL Bancontact KBC/CBC Payment Button Belfius Pay Button
I hereby give authorization to collect the recurring amount from my account periodically.

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