Aanmelding - IKC Cadans Barendrecht KDV

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)*

Nickname*

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

- Mijn kind mag herkenbaar op de foto op de website*

- Mijn kind mag herkenbaar op de foto op instagram en FB*

- Mijn kind mag herkenbaar op de foto in de ouderapp*

- Mijn kind mag herkenbaar op de foto op drukwerk (o.a. themakrant, nieuwsbrief, uitnodiging)*

- Mijn kind mag vervoerd worden in de elektrische BSO bus*

Parent/Guardian 1 (Who will receive the invoices)

Title

Initials*

Firstname*

Last name prefix

Last name*

Relationship

Date of birth*

Country of birth *

Nationality*

Spoken language*

Citizen Number (BSN)*

Highest education*

Profession

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*

Relationship

Date of birth

Country of birth *

Nationality*

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

City

Phone number (Home)

Mobilephone number

Phone number (work)

E-mail address

I agree with Privacy Statement

Registration for IKC Cadans Barendrecht KDV

Requested childcare

Child

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

Consent questions

Please fill with Yes or No to what applies

Parent/Guardian 1 (Who will receive the invoices)

Parent/Guardian 2

Emergency person