Aanmelding - Hadassa - Jasmijnstraat

EN | NL

Registration for Hadassa - Jasmijnstraat

Requested childcare

Op de Jasmijnstraat bieden we opvang aan voor de leeftijd 1.5 - 4 jaar

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

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

Mogen er foto's gemaakt worden van uw kind voor intern gebruik?
Mogen er foto's gemaakt worden van uw kind voor gebruik van sociaal media?
Mag uw kind mee op uitstapje?
Heeft uw kind een zwemdiploma?
Hebben beide ouders gezag?*
Is er een omgangregeling?*

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

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

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