Aanmelding - Kleinschalig kinderdagverblijf thuis bij Leonie

EN | NL

Registration for Kleinschalig kinderdagverblijf thuis bij Leonie

Requested childcare

Spelenderwijs leren en ontdekken met leuke thema's. Veel naar buiten en uitstapjes zoals naar peutergym, het bos in, speeltuinen en naar de ouderen vinden we erg leuk. Elk kind zien ontwikkelen op zijn eigen manier en tempo. Daar deel van uit mogen maken is het mooiste wat we mogen doen! Flexibel is voor de schoolgaande kinderen die af en toe nog mee komen te spelen, mocht er plek zijn. Dit gaat dan in overleg.

Startdate*
Enddate*

Full day childcare (KDV) Monday Tuesday Wednesday Thursday Friday

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

Flexible 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

Kinderen mogen in een passend stoeltje meer in de auto van de medewerkers*
*

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

n.v.t

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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