Aanmelding - Kinderopvang De Palmboom

EN | NL

Registration for Kinderopvang De Palmboom

Requested childcare

Startdate*
Enddate

Full day childcare (KDV) Monday Tuesday Wednesday Thursday Friday

Days before schoolcare (VSO) 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
Gender
Citizen number (BSN)

Allergies
Medication
Medical notes
Vaccinations
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?

Parent/Guardian 1 (Who will receive the invoices)

Title*
Initials*
Firstname
Last name prefix
Last name*
Relationship
Date of birth
Citizen Number (BSN)
Reffered for VVE (Preschool education)
Streetname*
House number*
House number extension
Postalcode (numbers)*
Postalcode (characters)*
City*
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)
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
BIC/SWIFT code (if applicable)