Aanmelding - PO De Vliegertjes

EN | NL

Registration for PO De Vliegertjes

Requested childcare

Beste ouder(s),

Hieronder kun je aangeven op welke dagen je peuteropvang nodig hebt.

Wensen kunnen worden aangegeven in het toelichtingen veld.

Voor meer informatie kun je onze website bekijken of contact met ons opnemen.

Startdate*
Enddate*

Remark

Child

You will be able to register another child after submitting the first registration

Initials*
First name*
Last name prefix
Last name*
Phonenumber (Incase of emergency)

Date of birth*
Estimated date of birth / Not yet born
Country of birth
Nationality*
Spoken language
Gender*
Citizen number (BSN)*

Allergies
Medication
Medical notes
Vaccinations*
Health insurance
Health insurance policy number
May be picked-up by

Doctor/General practitioner
If your Doctor/General practitioner is not mentioned in the list, can you please write them in the remark field above?

Consent questions

Please fill with Yes or No to what applies

Mag uw kind op de foto voor in de nieuwsbrief?
Mag er een foto van uw kind op de open social media van Sportify Kids?
Mag er een foto van uw kind gebruikt worden voor het digitale schriftje in de Ouderapp?

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials*
Firstname*
Last name prefix
Last name*
Date of birth*
Nationality
Spoken language
Citizen Number (BSN)*
Reffered for VVE (Preschool education)
Personal situation*
Combined income
Streetname*
House number*
House number extension
Postalcode (numbers)*
Postalcode (characters)*
City*
Country
Phone number (Home)
Mobile phone number*
Phonenumber (work)
E-mail address*
IBAN*
BIC/SWIFT code (if applicable)

Parent/Guardian 2

Title
Initials
Firstname
Last name prefix
Last name
Date of birth
Nationality
Spoken language
Citizen Number (BSN)
If you do not enter an address here, the address of parent/guardian 1 will be automatically taken over.
Streetname
House number
House number extension
Postalcode (numbers)
Postalcode (characters)
City
Country
Phone number (Home)
Mobile phone number
Phonenumber (work)
E-mail address
BIC/SWIFT code (if applicable)

Emergency person

Title
Initials
First name
Last name prefix
Last name
Relation
Date of birth
Citizen number (BSN)

Street
House number
House number extension
Postalcode (numbers)
Postalcode (characters)
City
Phone number (Home)
Mobilephone number
Phone number (work)
E-mail address

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