Registration form English Drama Classes 2015/2016
 Yes
I am a new student
 No
First and Last Name
M / F
Date of birth
Address
Postal Code and City
Home Telephone Number
Parents/Guardians
Mobile Number 1
Mobile Number Student
Parents/Guardians
Mobile Number 2
Email Parents/guardians 1 (Billing Address)
Email Parents/guardians 2
Email Student
School
Hobbies
Profession Parent 1
Profession Parent 2
Become a friend of RABARBER*
€ 25,-*
I want to volunteer, I want to help with:
Name:
 coaching children/actors
 clothing/make-up
September 2015 - April 2016
Age
Day

6/8-1
SAT

6/8-2
SUN

9/11-1
SAT

9/11-2
SUN

11/13-1
SAT

11/13-1
SUN
……… ,-*
*The tuition will be collected by direct debit
 cooking
 lobby/bar
Time
12:15-13:15
11:00-12:00
Classes
Drama: 1 hour
Drama: 1 hour
Costs
€210,€210,-
13:15-15:30
12:15-14:15
15:30:17:30
Drama: 1 hour; Dance: 1 hour
Drama: 1 hour; Dance: 1 hour
Drama: 1 hour; Dance: 1 hour
€310,€310,€310,-
14:00:16:00
Drama: 1 hour; Dance: 1 hour
€310,-
Registration fee (first year students only)
€ 25,Payment can only be made by direct debit. Please sign the authorization form below. Registration forms that are not completed or
without signature will not be processed.
-
-
Cancellation
Cancellation is only possible in writing.
- If you cancel before September 5th
2015, you will have to pay €25,registration fee and no tuition
- if you cancel before October 15th 2015
you will have to pay half of the tuition
- if you cancel after October 15th
2015 you will have to pay the full tuition
The tuition will be collected in two
installments. You will receive a separate
invoice by email
Mandate for recurrent collections
The undersigned agrees with the terms of payment and terms of lessons as stated in the
Terms and Conditions of Rabarber and authorizes Stichting Kindertheater Van Alles Wat
(credit id: NL53ZZZ411498600000), Bilderdijkstraat 35, Den Haag to collect the tuition
from his or her account. The tuition will be collected in two installments. You will receive a
separate invoice by email. As part of your rights, you are entitled to a refund from your
bank under the terms and conditions of your agreement with your bank. Ask your bank for
the conditions.
Name account holder
IBAN number
Signature account holder
Please sign this registration form and send ASAP to: Rabarber, Bilderdijkstraat 33, 2513 CM Den Haag