Aanmelding - BSO Knoet - Locatie Climax

EN | NL

Registration for BSO Knoet - Locatie Climax

Requested childcare

In de toelichting kunt u aangeven of u gebruik wilt maken van een 40 weken, 46 weken of 49 weken overeenkomst.

Vul als einddatum de datum in van het jaar waarin het kind 12 wordt. (Vb. Kind is jarig op 13-04-2011, einddatum wordt dan einde schooljaar 2023)

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
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

Mijn kind mag op foto's gezet worden en gepubliceerd worden op facebook, website etc*
Mijn kind mag zelf van de BSO naar huis fietsen
Mijn kind mag zelf van school naar de BSO fietsen
Mijn kind heeft zwemdiploma B*
Mijn kind heeft zwemdiploma A*

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials
Firstname*
Last name prefix
Last name*
Relationship
Date of birth*
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
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
BIC/SWIFT code (if applicable)

Emergency person

Title
Initials
First name
Last name prefix
Last name
Relation
Date of birth

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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