Aanmelding - Istia BSO Venlo Buitenkans

EN | NL

Registration for Istia BSO Venlo Buitenkans

Requested childcare

Geachte ouder/verzorger.

Bedankt voor uw interesse in BSO De Buitenkans. Om u zo goed mogelijk van dienst te kunnen zijn, willen wij u vragen, om de startdatum en de gewenste dagdelen aan ons door te geven. Dit kunt u aangeven bij de toelichting hieronder.

De mogelijkheden die wij bieden zijn: Middag opvang 13.15-17.45 uur Korte middag opvang 13.15-14.45 uur Late middag opvang 14.45-17.45 uur

Mochten er vragen zijn, dan kunt u deze bij de toelichting vermelden of telefonisch contact met ons opnemen.

Met vriendelijke groet, Team Istia Kinderopvang locatie Venlo

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
Spoken language
Gender
Citizen number (BSN)

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

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials
Firstname
Last name prefix
Last name*
Relationship
Date of birth
Spoken language
Highest education
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
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