Aanmelding - KDV Casa

EN | NL

Registration for KDV Casa

Requested childcare

Neemt u kind deel aan een vaccinatieprogramma van de overheid? Bij het vakje inentingen kunt u aangeven Ja Nee of Deels.

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
Nationality
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

Consent questions

Please fill with Yes or No to what applies

Mag er een foto/film van uw kind op facebook/social media?
Mag uw kind op de foto voor een interne nieuwsbrief?
Mag uw kind middels eigen vervoer deelnemen aan uitjes?

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials*
Firstname
Last name prefix
Last name*
Relationship
Date of birth*
Country 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*
Date of birth
Citizen number (BSN)

Street
House number
House number extension
Postalcode (numbers)
Postalcode (characters)
City
Mobilephone number*
Phone number (work)
E-mail address

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