Aanmelding - Sport-BSO Altena

EN | NL

Registration for Sport-BSO Altena

Requested childcare

Beste ouder/verzorger,

Hieronder vindt u het aanmeldformulier voor Sport-BSO Altena. U kunt aangeven hoeveel en welke dagen opvang gewenst is.

BSO inclusief: schooldagen en vakantiedagen

BSO exclusief: alleen schooldagen

De einddatum is naar schatting in te vullen. Wanneer u nog verdere vragen heeft over het aanmelden, kunt u contact opnemen via:

Mail: info@sportbsoaltena.nl

Telefoon: 0634186158

Startdate*
Enddate

Days and full vacationdays Monday Tuesday Wednesday Thursday Friday

Days without vacations Monday Tuesday Wednesday Thursday Friday

Only during school vacations 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
Nationality
Spoken language
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
If your Doctor/General practitioner 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

*
*
*
*

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials*
Firstname*
Last name prefix
Last name*
Relationship
Date of birth*
Nationality
Spoken language
Citizen Number (BSN)*
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

n.v.t

Title
Initials
Firstname
Last name prefix
Last name
Relationship
Date of birth
Nationality
Spoken language
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
Phone number (Home)
Mobile phone number
Phonenumber (work)
E-mail address

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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