Aanmelding - Minies kinderopvang Tilburg B.V.

EN | NL

Registration for Minies kinderopvang Tilburg B.V.

Requested childcare

Startdate*
Enddate*

Full day childcare (KDV) Monday Tuesday Wednesday Thursday Friday

Childcare in the morning (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
Citizen number (BSN)*

Nickname
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

3240

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials
Firstname*
Last name prefix
Last name*
Relationship
Date of birth
Spoken language
Citizen Number (BSN)*
Highest education
Streetname*
House number*
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
Last name prefix
Relationship
Spoken language
Highest education
Country
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
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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