Aanmelding - Keizer Karel/Bosbengels

EN | NL

Registration for Keizer Karel/Bosbengels

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
Gender
Citizen number (BSN)*

School/Classroom*
Medical notes
May be picked-up by

Consent questions

Please fill with Yes or No to what applies

Mag uw kind onder eigen verantwoording onder begeleiding meefietsen naar BSO locatie?*
Mag uw kind onder eigen verantwoording zelfstandig naar de opvanglocatie lopen/fietsen? *
Mag uw kind onder eigen verantwoording zelfstandig naar huis lopen/fietsen op een vooraf afgesproken tijdstip?*

Parent/Guardian 1 (Who will receive the invoices)

Initials*
Firstname*
Last name prefix
Last name*
Date of birth*
Citizen Number (BSN)*
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

Firstname
Last name prefix
Last name
Mobile phone number*
E-mail address

Emergency person

First name*
Last name*
Relation*

Mobilephone number*

Privacy Statement