Aanmelding - KDV De Lariks

EN | NL

Registration for KDV De Lariks

Requested childcare

Wilt u bij de toelichting invullen welke tijden u wenst te komen

Startdate*
Enddate*

Full day childcare (KDV) Monday Tuesday Wednesday Thursday Friday

Days afterschoolcare (NSO) 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
Country of birth
Nationality
Spoken language
Religion
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

Mag uw kind in het buiten bedje slapen?*
Mag uw kind met een foto in de nieuwsbrief?*
Mag uw kind met een foto op onze Instagram (alleen van de achterkant of bovenkant)?*
Mag uw kind vervoerd worden in de BSO bus? (oudste peuters en BSO kinderen)*
Mag uw kind in onze babyhangmat?*

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials*
Firstname
Last name prefix
Last name*
Relationship
Date of birth*
Country of birth
Nationality
Spoken language
Religion
Citizen Number (BSN)*
Highest education
Profession
Reffered for VVE (Preschool education)
Personal situation
Combined income
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
Country of birth
Nationality
Spoken language
Religion
Citizen Number (BSN)
Highest education
Profession
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
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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