Aanmelding - Mimine Zomer Club

EN | NL

Registration for Mimine Zomer Club

Requested childcare

De Zomer Club wordt aangeboden op specifieke dagen, tegen een tarief van €110 per dag.
Ouders kunnen hun kinderen inschrijven voor één of meerdere van de volgende data:
Week 1 – 6, 7 en 8 juli
Week 2 – 13, 14 en 15 juli
Week 3 – 20, 21 en 22 juli
Week 4 – 27, 28 en 29 juli
Week 5 – 3, 4 en 5 augustus
Week 6 – 10, 11 en 12 augustus
Graag in de toelichting aangeven van welke dagen u gebruik wilt maken van de Zomer Club.

Startdate*

Remark

Child

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

First name*
Last name*

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

Allergies
Medication
Vaccinations
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?

Parent/Guardian 1 (Who will receive the invoices)

Firstname
Last name*
Relationship
Date of birth*
Nationality
Citizen Number (BSN)*
Profession
Reffered for VVE (Preschool education)
Streetname
House number
Postalcode (numbers)
Postalcode (characters)
City
Phone number (Home)
Mobile phone number
Phonenumber (work)
E-mail address*
IBAN
BIC/SWIFT code (if applicable)

Parent/Guardian 2

n.v.t

Firstname
Last name
Relationship
Phone number (Home)
Mobile phone number
Phonenumber (work)
E-mail address

Emergency person

First name
Last name
Relation

Phone number (Home)
Mobilephone number
Phone number (work)
E-mail address

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