REGISTRATION FORM | Drumles 040

Name *

Initial and prefix *

Last name *

Geboortedatum leerling dag-maand-jaar *

Name of parent/guardian (if necessary)

E-mail address *

Street and house number *

ZIP code and address *

Phone number *

Lesson format *

30 minutes a week
45 minutes a week
60 minutes a week

PAYMENT DETAILS

Account holder name and surname *

Iban number *

Agree *

I hereby authorize Drumles040 to automatically debit the tuition fee due
I agree to the Terms and Conditions

Remark

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