Aanmelding - Kivido - TSO De Vliet *

EN | NL

Registration for Kivido - TSO De Vliet *

Requested childcare

Bij het verzenden van dit registratieformulier gaat u akkoord met het volgende:

Bij annulering van de opvang na registratie brengen wij eenmalig €15,00 euro administratiekosten in rekening. Dit wordt toegepast op het moment dat u het contract nog niet heeft ondertekend. Let op! Het gaat derhalve niet om de zogenaamde annuleringskosten waar naar verwezen wordt in artikel 4 en 7 van de Algemene Voorwaarden Kinderopvang.

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
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?

Parent/Guardian 1 (Who will receive the invoices)

Title*
Initials*
Firstname*
Last name prefix
Last name*
Relationship
Date of birth*
Nationality*
Spoken language*
Religion
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*
Nationality
Spoken language
Religion
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
Mobilephone number
Phone number (work)
E-mail address