Aanmelding - Alles Kids

EN | NL

Registration for Alles Kids

Requested childcare

Vrijdag is er geen opvang. U kunt de keuze maken tussen 7.30 -18.00 en 07:00 - 17.00. Graag aangeven in de toelichting.

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

Consent questions

Please fill with Yes or No to what applies

Mag uw kind in buikligging slapen?*
Mogen foto's/video's gebruikt worden voor intern gebruik? *
Mogen foto's gebruikt worden voor buiten, bijvoorbeeld voor de website?*
Mag uw kind op uitje onder begeleiding?*

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)*
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*

City
Phone number (Home)
Mobilephone number*
Phone number (work)
E-mail address

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