Aanmelding - De Wigwam TSO Eerbeek

EN | NL

Registration for De Wigwam TSO Eerbeek

Requested childcare

Mocht u gebruik willen maken van flexibele opvang dan kunt u alle dagen aanvinken en bij toelichting vermelden dat u volledig flexibel wilt komen.

Startdate*
Enddate

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

Parent/Guardian 1 (Who will receive the invoices)

Firstname
Last name prefix
Last name*
Date of birth
Streetname*
House number*
House number extension
Postalcode (numbers)*
Postalcode (characters)*
City*
Country
Phone number (Home)
Mobile phone number
Phonenumber (work)
E-mail address*
IBAN*

Parent/Guardian 2

Firstname
Last name prefix
Last name
Date of birth
Phone number (Home)
Mobile phone number
Phonenumber (work)
E-mail address

Emergency person

First name
Last name prefix
Last name
Relation

Street
House number
House number extension
Postalcode (numbers)
Postalcode (characters)
City
Phone number (Home)
Mobilephone number
Phone number (work)