Aanmelding - Stichting BSO ProKidz

EN | NL

Registration for Stichting BSO ProKidz

Requested childcare

Wij verzoeken u duidelijk door te geven welk contractvorm u aangaat. U kunt kiezen uit: 52 weken, 46 weken, 40 weken, 12 weken. Vult u dat hieronder in. Er is tevens ruimte voor andere zaken die u kwijt wilt.

Startdate*
Enddate

Days before schoolcare (VSO) Monday Tuesday Wednesday Thursday Friday

Days afterschoolcare (NSO) Monday Tuesday Wednesday Thursday Friday

Days including 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

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
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

Mag uw kind zelfstandig naar huis?
Mag uw kind zelfstandig van school naar de BSO?
Mag uw kind door broers of zussen jonger dan 18 jaar worden opgehaald?
Mag uw kind varkensvleesproducten?
Geeft u ons toestemming om uw kind op 2 basisgroepen te plaatsen?
Mag uw kind onder begeleiding vanaf school meefietsen naar de BSO?

Parent/Guardian 1 (Who will receive the invoices)

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

Privacy Statement