REGISTRATION FORM - LEARN DUTCH IN DC
2023-2024
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Levels of the classes offered:
Beginner: No prior courses in Dutch, nor other experience with the Dutch language.

Beginner plus: You took a basic Dutch course or acquired sufficient knowledge to participate in simple conversations. You can express yourself in the present tense. You are ready to start using more complex sentences, past tenses and expand your vocabulary in a wider range of topics.

Intermediate: You are familiar with most Dutch syntax and grammar rules, are comfortable expressing yourself in a variety of everyday situations and are looking to expand your knowledge by learning more complex language constructs.

Advanced: You are comfortable in more complex conversations, can discuss current affairs and are ready to significantly expand your vocabulary.

I would like to sign up for: *
If ADVANCED, please indicate your  preference for zoom, or in-person:
If not sure, tell us about your level of Dutch:
INFORMATION:
Last name: *
First name *
Street: *
City: *
State: *
Zipcode: *
Home phone:
Mobile phone: *
E-mail: *
Date (mm/dd/yyyy):
Waiver
I, individually, and my respective heirs, successors, and personal representatives, hereby release, acquit and forever discharge the Bethesda Dutch After School Program, Inc. and their teachers and teacher aides, students, parent volunteers, agents, board members, officers, trustees and representatives (in their official and individual capacities) from any and all liability whatsoever for any and all damages, losses or injuries, including death, to persons or property or both, including but not limited to any claims, demands, actions, causes of action, damages, costs, expenses and attorneys fees, which arise out of, during or in connection with my participation in the aforementioned lessons and activities, including but not limited to any damages, losses, or injuries to persons or property or both, which may be sustained or suffered by my child or any person in connection with my association with, or participation in, activities at, sponsored by, or arising out of the schools activities and meetings.

I hereby acknowledge and agree that this Waiver and Release of Liability is intended to be as broad and inclusive as permitted by law. If any provision of this Waiver and Release of Liability is, for any reason, held to be illegal, invalid, or unenforceable, the remaining provisions of this Waiver and Release of Liability shall be unimpaired and the invalid or unenforceable provisions will be deemed modified so that it is valid and enforceable to the maximum extent permitted by law. This Waiver and Release of Liability shall be governed by the laws of the State of Maryland.

At all times the Bethesda Dutch After School Program, Inc., and its board members, directors, officers, administrators, staff (teachers and teaching assistants), employees, volunteers and agents,  are authorized to take any measures necessary for my protection during the hours of the school's classes and events.

I hereby certify that I have read this Waiver and Release of Liability in its entirety; that I fully understand its contents and the impact on my legal rights, and that I have knowingly and voluntarily signed below.


Name: *
Date (mm/dd/yyyy): *
Payment
Classes are $ 775, this includes all materials.
You will be able to pay for classes by e-check or by credit card.

Payment by e-check (ACH), directly from your bank account.  If you choose this payment method, you will receive an e-mail with a link to a secure payment page for submitting your bank information prior to the start of classes.

Payment by credit card. If you choose this payment method, you will receive a credit card authorization form by e-mail to authorize the Bethesda Dutch School to charge your credit card for the tuition amount. If you choose this option, you will be charged an additional $ 25 in credit card processing costs.

Payment by check or cash are not possible.


The payment option I choose is: *
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