Aanmelding - Bij Boer Bas

EN | NL

Registration for Bij Boer Bas

Requested childcare

Beste ouders,

U staat op het punt om een aanmelding te doen Bij Boer Bas. Wanneer u nog in verwachting bent dan kunt u bij geboorte data het kopje ' geschatte geboorte datum' invullen.

Wanneer er om de naam gevraagd wordt kunt u: baby o.i.d invullen.

We zien jullie aanmelding graag tegemoet,

Vriendelijke groeten, Maaike de Wildt.

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
Spoken language
Gender
Citizen number (BSN)*

Nickname
Allergies
Medication
Medical notes
Vaccinations
Health insurance
Health insurance policy number
May be picked-up by

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
Profession
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)
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

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

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