Aanmelding - Kindrijk Veldhuizen - Safari PO

EN | NL

Registration for Kindrijk Veldhuizen - Safari PO

Requested childcare

Heeft u geen recht op kinderopvangtoeslag, maar ontvangt u een vergoeding voor de opvang via de gemeente? Geef dit dan aan in de toelichting.

Heeft uw kindje een VVE- indicatie? Geef dit dan ook aan in de toelichting.

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
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
Dentist
If your Doctor/General practitioner/Dentist 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

*
*
*
*
*
*
*
15970
15971

Parent/Guardian 1 (Who will receive the invoices)

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

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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