Aanmelding - Coffee and Kids BSO

EN | NL

Registration for Coffee and Kids BSO

Requested childcare

Woensdagen en vrijdagen zijn we nog niet geopend. We zullen u op de hoogte brengen zodra de woensdagen en vrijdagen wel aangeboden worden.

We willen u vragen om in het Toelichtingen veld een uitleg te geven van uw opvoedkundige waarden.

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
School/Classroom*
Allergies*
Medication*
Medical notes
Vaccinations*
Health insurance
Health insurance policy number
May be picked-up by

Doctor/General practitioner*
If your Doctor/General practitioner 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 mee op reis/uitjes?*
Mag uw kind mee met het Openbaar Vervoer?*
Mag uw kind op de foto voor intern gebruik?*
Mag uw kind op de foto voor sociale media (Extern gebruik)?*

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
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
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
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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