Aanmelding - BSO Boom

EN | NL

Registration for BSO Boom

Requested childcare

Welkom bij Bloem

Middels de registratie kunt u uw kindje(s) inschrijven voor onze opvang.
Wij zullen u zo spoedig mogelijk op de hoogte brengen van de mogelijkheden.
Na uw inschrijving ontvangt u binnen 5 werkdagen reactie van ons.

Hartelijke groet,

Team Bloem

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

Initials*
First name*
Last name prefix
Last name*

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 met foto's (zonder naam) op onze socials (FB/instagram)?*
Mag uw kind met foto's van de rug (zonder naam) op onze socials (FB/instagram)?*
Heeft u interesse om deel te nemen aan de oudercommissie?*
Wilt u informatie over de oudercommissie ontvangen via de mail?*
Heeft uw kind zwemdiploma B behaald?
Heeft uw kind zwemdiploma A behaald?
15713

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
Personal situation
Combined income
Streetname*
House number*
House number extension
Postalcode (numbers)*
Postalcode (characters)*
City*
Country
Phone number (Home)*
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
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)
Phonenumber (work)
E-mail address
BIC/SWIFT code (if applicable)

Emergency person

Title*
Initials
First name*
Last name prefix
Last name*
Relation*

Phone number (Home)*

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