Aanmelding - Kinderopvang Madelief

EN | NL

Registration for Kinderopvang Madelief

Requested childcare

Wij hanteren een minimale afname van 2 dagdelen aaneengesloten per week.

Aanmeldgeld a 50,- over te maken op bankrekeningnr. NL81 ABNA 0618 8237 94 Tenaamstelling: Kinderopvang Madelief

Startdate*
Enddate*

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

Childcare in the afternoon (KDV) 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
Spoken language
Gender
Citizen number (BSN)

Nickname
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

Wilt u de nieuwsbrief ontvangen?

Parent/Guardian 1 (Who will receive the invoices)

Title
Initials
Firstname
Last name prefix
Last name*
Relationship
Date of birth
Spoken language
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)
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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