• Dutch School Silicon Valley registration form

    2026-2027

  • Contact information

  • How many students do you want to enroll?*

  • 1. Student Information

    Student #1
  • 1. Sex*
  • 1. Date of birth*
     / /
  • 1. Preferred program - Class schedule is finalized in August. Class times and dates will be determined based upon family, teacher and classroom availability.*
  • 1. Attend the "Spreek en speelbende" program? Only for elementary school students. Location Palo Alto, $550 per school year.*
  • 1. Does your child have a learning challenge and/or an Individual Education Plan (IEP)*
  • 1. Date of your child’s last tetanus shot*
     - -

  • 2. Student Information

    Student #2

  • 2. No second student

  • 2. Sex*
  • 2. Date of birth*
     - -
  • 2. Preferred program - Class schedule is finalized in August. Class times and dates will be determined based upon family, teacher and classroom availability.*
  • 2. Attend the "Spreek en speelbende" program? Only for elementary school students. Location Palo Alto, $550 per school year.*
  • 2. Does your child have a learning challenge and/or an Individual Education Plan (IEP)*
  • 2. Date of your child’s last tetanus shot*
     - -

  • 3. Student Information

    Student #3

  • 3. No third student

  • 3. Sex*
  • 3. Date of birth*
     - -
  • 3. Preferred program - Class schedule is finalized in August. Class times and dates will be determined based upon family, teacher and classroom availability.*
  • 3. Attend the "Spreek en speelbende" program? Only for elementary school students. Location Palo Alto, $550 per school year.*
  • 3. Does your child have a learning challenge and/or an Individual Education Plan (IEP)*
  • 3. Date of your child’s last tetanus shot*
     - -

  • Emergency Information

  • In case of an emergency we will contact the Primary Contact, if we cannot get hold of this first contact we will contact Secondary Contact. When both parents/legal guardians cannot be reached, we will contact the Emergency Contact provided to us in this form.

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • I understand that, as standard procedure, my child(ren) will only be released to the persons registered in this form. I would like to add the following person(s) as possible adult(s) that my child(ren) may be released to, after I have given notice of this to the teacher (Grandma/Grandpa/Nanny etc). Please fill out their first and last name and relationship to the student.

  • Authorization (in case of emergency)

    I, hereby, authorize the Dutch School Silicon Valley (the “School”), and its board members, directors, officers, administrators, staff (a.o. teachers and teaching assistants), employees, volunteers and agents, to take any measures necessary for the protection of my child(ren) during the hours of the DSSV classes and events.

  • Relation to the Dutch language

  • Number of parents with Dutch as primary language*
  • Nationality of Parents and Students (choose all that apply)

  • For Parents By Parents: Volunteer Positions

    DSSV is a 501 (c) (3) nonprofit organization. As such, our school also depends on donations from our families in time, talent, and monetary means to provide the best education to our students. Let us know in what form you would like to participate in creating the best possible educational experience for our children. All in-class volunteer positions are on a rotating schedule. 
  • I'm interested in the following volunteer position:*

  • How did you find the Dutch School of Silicon Valley?

  • Referred via*

  • Enrollment, cancellation and tuition terms

  • After registering the DSSV will try to place your student(s) in the best class. Only when your student is placed in a class will the tuition charges apply.

     

    Automatic enrollment 

    Your child's enrollment within a program will automatically carry over to the next school year, unless either (a) you cancel before June 30 before the start of the new school year or (b) your child graduates from a program (such as graduating from the Pre-School program.  

     

    Cancellation policy

    The school uses a cancellation period of 30 days.

    - For a child on a monthly payment schedule, School tuition will be charged for the 30 days after the first day of the month following the submission date of the cancellation request. 

    - For a child on an annual payment schedule, DSSV will issue a prorated refund for your child’s unused tuition fees, starting 30 days after the first day of the month following the submission date of cancellation request.

    You may cancel your child's enrollment by emailing the director and treasurer via  director@dutchschoolsiliconvalley.org and penningmeester@dutchschoolsiliconvalley.org.

     

  • Tuition Payment Options

  • After registering the DSSV will try to place your student(s) in the best class. Only when your student is placed in a class will the tuition charges apply.

     

    Tuition per program

    • Pre-School (peuters) program, ages 2.5 to 4 (one class every 3 to 4 weeks): $550 per school year
    • Elementary, middle and high school program (weekly, in-person and hybrid): $1725 per school year (USD 195/month)  
    • Spreek en Speelbende (one class every 3 to 4 weeks): $550 per school year - enrollment in elementary required
    • Private lessons - only after approval of the director: $80 per hour

    Annual tuition is subject to change for the next school year. Annual tuition will be communicated before June 15, ahead of the next school year.

  • Tuition Payments, for elementary, middle and high school only*

  • Payment Method

    The School has a prefence for use of direct bank-to-bank transfers (ACH) to reduce transfer costs and required volunteer time, and to eliminate additional costs for you. 

    The school will set up an automatic payment schedule with the bank account of your choice. Please take care when filling in the numbers as to prevent errors. 

  • Type of Bank Account

  • Waive and release

  • The undersigned (the “Signer”), being the parent(s) and/or legal guardian(s) of the minor child(ren) (the “student”) named at the beginning of this form, for valuable and sufficient consideration, receipt of which is hereby acknowledged, on behalf of themselves and the Child do hereby knowingly and intentionally fully and irrevocably release, to the full extent permitted by California law, the Dutch School Silicon Valley (the “School”), and its board members, directors, officers, sponsors, administrators, staff (e.g. teachers and teaching assistants), employees, volunteers and agents, from any and all claims or liability, known or unknown, of any kind whatsoever, which may now exist, or at any time in the future arise, with regard to any matters relating, directly or indirectly, to the student's enrollment or attendance at the School, or to the Signer’s or the student's participation in any activities directly or indirectly related to, or sponsored or sanctioned by, the School, regardless of whether or not said activities occur on School premises or elsewhere. By our initials below and by our signatures at the end of this form, we knowingly waive and release any and all legal claims that we or the child(ren) may now or in the future have against the School, or anyone connected with it.

    At all times the school staff is authorized to take any measures necessary for the protection of my child(ren).

  • We truthfully filled out this registration and understand what to do next.

    To the best of our knowledge, all the information filled in on this registration form is true and complete. We understand that payment of the required fees must be made by the payment deadlines outlined. Our signatures below affirm all of the above.

  • We authorize the school to open an account for the student with the Openbare Bibliotheek Amsterdam and provide access to Dutch language e-books and other resources. 

  • The students enrolling via this registration have received all immunizations required by the CDC for school and child care entry.

  • Should be Empty: