Aanmelding - Kinderopvang De Broekies

EN | NL

Registration for Kinderopvang De Broekies

Requested childcare

Peuteropvang is alleen aan te vragen voor de maandag of donderdagochtend van 8:30-12:00

Verlengde opvang aanvragen voor en na de peuteropvang is ook mogelijk. Geef dit dan aan bij opmerkingen.

Voor flexibele opvang hanteren wij een minimale afname van 8 uren per keer

Startdate*
Enddate*

Full day childcare (KDV) Monday Tuesday Wednesday Thursday Friday

Childcare in the morning (KDV) Monday Tuesday Wednesday Thursday Friday

Childcare in the afternoon (KDV) Monday Tuesday Wednesday Thursday Friday

Toddlercare in the morning (PO) Monday Tuesday Wednesday Thursday Friday

Days afterschoolcare (NSO) Monday Tuesday Wednesday Thursday Friday

Flexible Monday Tuesday Wednesday Thursday Friday

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
Spoken language
Gender
Citizen number (BSN)*

Nickname
School/Classroom
Allergies
Medication
Medical notes
Vaccinations
Health insurance
Health insurance policy number
May be picked-up by

Doctor/General practitioner
Dentist
If your Doctor/General practitioner/Dentist 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

Gaat u, ouder(s)/verzorger(s), akkoord met het gebruik van beeldmateriaal van uw kind op de website van de kinderopvang?
Gaat u, ouder(s)/verzorger(s), akkoord met het gebruik van beeldmateriaal van uw kind in andere media?

Parent/Guardian 1 (Who will receive the invoices)

Initials*
Firstname
Last name prefix
Last name*
Relationship
Date of birth*
Spoken language
Citizen Number (BSN)*
Highest education
Profession
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*
Relationship
Date of birth*
Spoken language
Citizen Number (BSN)*
Highest education
Profession
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

Phone number (Home)

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