Aanmelding - Villa Kiekeboe

EN | NL

Registration for Villa Kiekeboe

Requested childcare

De standaard opvang is van 7.30 - 18.00. Wilt u vanaf 7.00 en/of tot 18.30 dan kunt u dit aangeven in de toelichting.

Startdate*
Enddate*

Full day childcare (KDV) Monday Tuesday Wednesday Thursday Friday

Childcare in the morning (KDV) Monday Tuesday Wednesday Thursday Friday

Childcare in the afternoon (KDV) Monday Tuesday Wednesday Thursday Friday

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

Nickname
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

inbakeren baby
zijligging en buik slapen
samen op pad
toestemming voor het samenvoegen van groepen
toestemming voor de overdracht naar de basisschool
toestemming foto delen social media
toestemming plaatsen foto's eigen groep
vervoer in bakfiets en bolderkar
buiten slapen in buiten huisjes
opvangen van kinderen op de2de stamgroep

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials
Last name prefix
Last name*
Relationship
Spoken language
Country
E-mail address
BIC/SWIFT code (if applicable)

Parent/Guardian 2

Title
Initials
Firstname
Last name prefix
Last name
Relationship
Date of birth
Spoken language
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

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