Aanmelding - Het Peuterhuis locatie Zuilenburg

EN | NL

Registration for Het Peuterhuis locatie Zuilenburg

Child

You will be able to register another child after submitting the first registration

Initials*
First name*
Last name prefix
Last name*

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

Nickname*
Allergies*
Medication
Medical notes
Vaccinations*
May be picked-up by

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials*
Firstname*
Last name prefix
Last name*
Date of birth*
Citizen Number (BSN)*
Profession
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
Date of birth
Citizen Number (BSN)
Profession
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)
BIC/SWIFT code (if applicable)

Emergency person

Initials
First name
Last name prefix
Last name
Relation

Phone number (Home)
Mobilephone number
Phone number (work)