Aanmelding - De Paddestoel Aletta

EN | NL

Registration for De Paddestoel Aletta

Requested childcare

Welkom bij de Kabouters. Onderstaande het aanmeldformulier. Wilt u bij de toelichting aangeven of u voor een 52 weken, 40 weken of een flex-contract kiest.

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

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*

Date of birth*
Estimated date of birth / Not yet born
Country of birth *
Nationality
Gender*
Citizen number (BSN)

Nickname
Allergies
Medication
Medical notes
Vaccinations*
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 uw kind in het buitenbedje slapen? *
Mag uw kind met een foto in de nieuwsbrief?*
Mag uw kind vervoerd worden in de BSO bus? (oudste peuters en BSO kinderen)*
Mag uw kind onherkenbaar met een foto op onze Instagram?*

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials
Firstname*
Last name prefix*
Last name*
Relationship*
Date of birth*
Spoken language*
Citizen Number (BSN)*
Streetname*
House number*
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)
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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