Aanmelding - BSO Speelland Apollo

EN | NL

Registration for BSO Speelland Apollo

Requested childcare

Beste ouder/verzorger, BSO Apollo is op dit moment geopend op maandag, dinsdag en donderdag. Zou je op andere dagen ook graag gebruik willen maken van de BSO?

Dit is mogelijk op locatie Storm. Op deze dagen worden de kinderen met de Speelland Shuttle van BSO Apollo naar BSO Storm gebracht. Dit vervoer maakt onderdeel uit van de opvang op deze dagen (geen extra kosten aan verbonden)

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
Religion
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

Mag je kind mee op uitstapjes zonder vooraankondiging? (denk aan het park, speeltuin etc)*
16562
*

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
Religion
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

n.v.t

Title
Initials
Firstname
Last name prefix
Last name
Relationship
Date of birth
Country of birth
Nationality
Spoken language
Religion
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
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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