Registration Form Early Years First Aid Course

1. Applicant
Gender:
First name: *
Last name: *
Street: *
House number: *
Postal code: *
City: *
Telephone number (home):
Telephone number (work):
Mobile number:
Email: *
Nationality:


2. Partner or spouse
Gender:
First name:
Last name:
  Register my partner/spouse as participant
3. Course date
Date and location:
*for parents (€119 pp)
**certified childminders/teachers (€165 pp)
***certified refreshers training (€95 pp)
4. Referral
How did you find Blue Umbrella


5. Questions or Comments
X

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  • If the amounts to be paid or the payment dates change Blue Umbrella will notify you 5 working days in advance of your account being debited or as otherwise agreed.
  • If an error is made by Blue Umbrella or your Bank, you are guaranteed a full and immediate refund from the amount paid.
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6. Terms & conditions
I have read and agree to the Terms and conditions and to receive important communications from Blue Umbrella electronically.
7. Payment
Select a payment option
Direct Debit
Bank transfer


(Surcharge € 5.00)

Dutch bank account only.




Please transfer the applicable Blue course fee:

Blue Umbrella Amsterdam
ING Bank account 5330215
IBAN: NL 46 INGB 0005330215
BIC(SWIFT): INGBNL2A

Reference: Blue First aid course and applicants name


Direct Debit. Dutch bank account only. No surcharge
Bank account number:
Name account holder:
Direct Debit Guarantee
Contact Us

E-mail info@blueumbrella.nl

Telephone +31 (0)20 4687560
Facsimile +31 (0)20 4687560

Mailing Address:
Blue Umbrella
P.O. Box 17208
1001 JE Amsterdam
The Netherlands