Aanmelding - POV De Smurfen LHH

EN | NL

Registration for POV De Smurfen LHH

Requested childcare

POV 'De Smurfen Lierderholthuis is vanaf september 2026 uitsluitend geopend op woensdagochtend. Wel is het mogelijk om ook een 2e dagdeel aan te geven, zodat we kunnen inventariseren wanneer er behoefte is voor meerdere dagdelen POV.

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*
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?

Parent/Guardian 1 (Who will receive the invoices)

Initials*
Firstname
Last name prefix
Last name*
Relationship
Date of birth*
Country of birth
Nationality
Spoken language
Citizen Number (BSN)*
Highest education
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*

Parent/Guardian 2

n.v.t

Title
Initials
Firstname
Last name prefix
Last name
Relationship
Date of birth
Nationality
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

Emergency person

First name
Last name prefix
Last name
Relation

Street
House number
City
Phone number (Home)
Mobilephone number

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