Aanmelding - Wiskids

EN | NL

Registration for Wiskids

Requested childcare

Wilt u bij toelichting aangeven welke van de ondestaande tijden u graag wilt afnemen.
1. 8.00-18.00 uur
2. 7.30-18.00 uur
3. 8.00-18.30 uur
4. 7.30-18.30 uur

Startdate*
Enddate*

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*

Nickname
Allergies
Medication
Medical notes
Vaccinations
Health insurance
Health insurance policy number
May be picked-up by

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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