Internet Zwemscore Module

First name*

Surname prefix

Last name*

Date of birth*

Gender*

Boy Girl

Street*

House number*

Zip code*

City*

Phone number*

Mobile

Name of account holder*

IBAN*

Email address*

Spoken language ?

English
Other
Special needs?

Explanation

Locations:
Lessons in The Hague at Overbosch, Vlaskamp 3-5
Lessons in Scheveningen at de Blinkerd, Seinpoststraat 150

Location*

Availability

Comment

Payment method

With your signature you allow and authorize Swimkids to withdraw equal payments from your bank account every month.

The monthly fee may vary, depending on the number of lessons offered during that month.
Transfer
iDeal

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