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U wordt geadviseerd om de nieuwste versie te downloaden en te installeren! </p> <![endif]--> </div> </div> <div class='logo_container logo'></div> <div id='new_child_form'> <h2>Aanmelding voor Kinderopvang Bloem Breda B.V.</h2> <h3></h3> <form accept-charset="UTF-8" action="/external/registrations" class="formtastic registration" id="new_registration" method="post" novalidate="novalidate"><div style="margin:0;padding:0;display:inline"><input name="utf8" type="hidden" value="✓" /><input name="authenticity_token" type="hidden" value="YKvKZKHSix0I/Wf2/tPPpmbdEIeDTXm+6nk9jTtfndE=" /></div><input id="registration_token" name="registration_token" type="hidden" value="dE6eokxCpMryB638hvMP" /> <div class='form_group' id='parent'> <h3 class='registration'>Toelichting</h3> <h4><p>Welkom bij Kinderopvang Bloem Breda! <br> Middels de registratie kunt u uw kindje(s) inschrijven voor onze opvang in het kinderdagverblijf of de peutergroep. <br> In de toelichting kunt u aangeven als u 40 weken opvang wilt en op welke locatie u opvang wilt. <br> Locatie op Cornelis Florisstraat of Locatie Epelenberg. <br> Wij zullen u zo spoedig mogelijk op de hoogte brengen van de mogelijkheden. <br> Na uw inschrijving ontvangt u binnen 5 werkdagen reactie van ons. <br> <br> Hartelijke groet, <br> </p> <h2>Team KOV Bloem Breda</h2> <p>Welcome at Kinderopvang Bloem Breda! <br> Via this registration you can enlist your child(ren) for day-care at our nursery or pre-school. <br> In the comment box you can let us know when you would wish a 40weeks contract and you can indicate on which location you would like to register your child(ren). <br> Locations at the Cornelis Florisstraat or Location Epelenberg. <br> We shall inform you as soon as possible on the possibilities. <br> After your registration you will receive notice within 5 working days. <br> <br> Kind Regards, <br> Team KOV Bloem Breda</p> </h4> <br> <fieldset class="inputs"><ol><li class="string input required stringish" id="registration_preferred_start_date_input"><label class=" label" for="registration_preferred_start_date">Startdatum<abbr title="required">*</abbr></label><input id="registration_preferred_start_date" name="registration[preferred_start_date]" type="text" /> </li> <li class="string input required stringish" id="registration_preferred_end_date_input"><label class=" label" for="registration_preferred_end_date">Einddatum<abbr title="required">*</abbr></label><input id="registration_preferred_end_date" name="registration[preferred_end_date]" type="text" /> </li> </ol></fieldset><fieldset class='inputs'> <ol> <li class='input'> <label class='label'>Hele dag KDV</label> <input id="monday_days" name="monday_days" type="checkbox" value="true" /> Maandag <input id="tuesday_days" name="tuesday_days" type="checkbox" value="true" /> Dinsdag <input id="wednesday_days" name="wednesday_days" type="checkbox" value="true" /> Woensdag <input id="thursday_days" name="thursday_days" type="checkbox" value="true" /> Donderdag <input id="friday_days" name="friday_days" type="checkbox" value="true" /> Vrijdag </li> </ol> </fieldset> <fieldset class='inputs'> <ol> <li class='input'> <label class='label'>Ochtend KDV</label> <input id="monday_kdv_morning" name="monday_kdv_morning" type="checkbox" value="true" /> Maandag <input id="tuesday_kdv_morning" name="tuesday_kdv_morning" type="checkbox" value="true" /> Dinsdag <input id="wednesday_kdv_morning" name="wednesday_kdv_morning" type="checkbox" value="true" /> Woensdag <input id="thursday_kdv_morning" name="thursday_kdv_morning" type="checkbox" value="true" /> Donderdag <input id="friday_kdv_morning" name="friday_kdv_morning" type="checkbox" value="true" /> Vrijdag </li> </ol> </fieldset> <fieldset class='inputs'> <ol> <li class='input'> <label class='label'>Middag KDV</label> <input id="monday_kdv_afternoon" name="monday_kdv_afternoon" type="checkbox" value="true" /> Maandag <input id="tuesday_kdv_afternoon" name="tuesday_kdv_afternoon" type="checkbox" value="true" /> Dinsdag <input id="wednesday_kdv_afternoon" name="wednesday_kdv_afternoon" type="checkbox" value="true" /> Woensdag <input id="thursday_kdv_afternoon" name="thursday_kdv_afternoon" type="checkbox" value="true" /> Donderdag <input id="friday_kdv_afternoon" name="friday_kdv_afternoon" type="checkbox" value="true" /> Vrijdag </li> </ol> </fieldset> <fieldset class='inputs'> <ol> <li class='input'> <label class='label'>Peuteropvang ochtend</label> <input id="monday_toddler_morning" name="monday_toddler_morning" type="checkbox" value="true" /> Maandag <input id="tuesday_toddler_morning" name="tuesday_toddler_morning" type="checkbox" value="true" /> Dinsdag <input id="wednesday_toddler_morning" name="wednesday_toddler_morning" type="checkbox" value="true" /> Woensdag <input id="thursday_toddler_morning" name="thursday_toddler_morning" type="checkbox" value="true" /> Donderdag <input id="friday_toddler_morning" name="friday_toddler_morning" type="checkbox" value="true" /> Vrijdag </li> </ol> </fieldset> <fieldset class='inputs'> <ol> <li class='input'> <label class='label'>Dagen VSO</label> <input id="monday_vso" name="monday_vso" type="checkbox" value="true" /> Maandag <input id="tuesday_vso" name="tuesday_vso" type="checkbox" value="true" /> Dinsdag <input id="wednesday_vso" name="wednesday_vso" type="checkbox" value="true" /> Woensdag <input id="thursday_vso" name="thursday_vso" type="checkbox" value="true" /> Donderdag <input id="friday_vso" name="friday_vso" type="checkbox" value="true" /> Vrijdag </li> </ol> </fieldset> <fieldset class='inputs'> <ol> <li class='input'> <label class='label'>Dagen NSO</label> <input id="monday_nso" name="monday_nso" type="checkbox" value="true" /> Maandag <input id="tuesday_nso" name="tuesday_nso" type="checkbox" value="true" /> Dinsdag <input id="wednesday_nso" name="wednesday_nso" type="checkbox" value="true" /> Woensdag <input id="thursday_nso" name="thursday_nso" type="checkbox" value="true" /> Donderdag <input id="friday_nso" name="friday_nso" type="checkbox" value="true" /> Vrijdag </li> </ol> </fieldset> <fieldset class='inputs'> <ol> <li class='input'> <label class='label'>Dagen incl. vakantie</label> <input id="monday_holiday" name="monday_holiday" type="checkbox" value="true" /> Maandag <input id="tuesday_holiday" name="tuesday_holiday" type="checkbox" value="true" /> Dinsdag <input id="wednesday_holiday" name="wednesday_holiday" type="checkbox" value="true" /> Woensdag <input id="thursday_holiday" name="thursday_holiday" type="checkbox" value="true" /> Donderdag <input id="friday_holiday" name="friday_holiday" type="checkbox" value="true" /> Vrijdag </li> </ol> </fieldset> <fieldset class='inputs'> <ol> <li class='input'> <label class='label'>Alleen vakantieopvang</label> <input id="monday_only_holiday" name="monday_only_holiday" type="checkbox" value="true" /> Maandag <input id="tuesday_only_holiday" name="tuesday_only_holiday" type="checkbox" value="true" /> Dinsdag <input id="wednesday_only_holiday" name="wednesday_only_holiday" type="checkbox" value="true" /> Woensdag <input id="thursday_only_holiday" name="thursday_only_holiday" type="checkbox" value="true" /> Donderdag <input id="friday_only_holiday" name="friday_only_holiday" type="checkbox" value="true" /> Vrijdag </li> </ol> </fieldset> <fieldset class="inputs"><ol><li class="text input optional" id="registration_remarks_input"><label class=" label" for="registration_remarks">Toelichting</label><textarea id="registration_remarks" name="registration[remarks]" rows="20"> </textarea> </li> </ol></fieldset> </div> <div class='clear'></div> <div class='form_group' id='parent'> <h3 class='registration'>Kind</h3> <h4>U kunt eventueel nog een kind registreren na het invoeren van deze aanmelding.</h4> <fieldset class="inputs"><ol><li class="string input optional stringish" id="registration_child_attributes_initials_input"><label class=" label" for="registration_child_attributes_initials">Initialen</label><input id="registration_child_attributes_initials" maxlength="10" name="registration[child_attributes][initials]" type="text" /> </li> <li class="string input required stringish" id="registration_child_attributes_firstname_input"><label class=" label" for="registration_child_attributes_firstname">Voornaam<abbr title="required">*</abbr></label><input id="registration_child_attributes_firstname" maxlength="255" name="registration[child_attributes][firstname]" type="text" /> </li> <li class="string input optional stringish" id="registration_child_attributes_in_between_first_and_lastname_input"><label class=" label" for="registration_child_attributes_in_between_first_and_lastname">Tussenvoegsel</label><input id="registration_child_attributes_in_between_first_and_lastname" maxlength="10" name="registration[child_attributes][in_between_first_and_lastname]" type="text" /> </li> <li class="string input required stringish" id="registration_child_attributes_lastname_input"><label class=" label" for="registration_child_attributes_lastname">Achternaam<abbr title="required">*</abbr></label><input id="registration_child_attributes_lastname" maxlength="255" name="registration[child_attributes][lastname]" type="text" /> </li> <li class="string input optional stringish" id="registration_child_attributes_emergency_phone_input"><label class=" label" for="registration_child_attributes_emergency_phone">Telefoon (bij nood)</label><input id="registration_child_attributes_emergency_phone" maxlength="255" name="registration[child_attributes][emergency_phone]" type="text" /> </li> </ol></fieldset><fieldset class="inputs"><ol><li class="string input optional stringish" id="registration_child_attributes_date_of_birth_input"><label class=" label" for="registration_child_attributes_date_of_birth">Geboortedatum</label><input id="registration_child_attributes_date_of_birth" name="registration[child_attributes][date_of_birth]" type="text" /> </li> <li class='string input optional stringish' id='registration_child_attributes_disable_bsnr_input'> <label class='label' for='registration_child_attributes_disable_bsnr'> Geschatte geboortedatum </label> <input name="registration[child_attributes][disable_bsnr]" type="hidden" value="0" /><input id="registration_child_attributes_disable_bsnr" name="registration[child_attributes][disable_bsnr]" type="checkbox" value="1" /> </li> <li class='input optional select' id='registration_child_attributes_homeland_input'> <label class='label' for='registration_child_attributes_homeland'> Geboorteland </label> <select id="registration_child_attributes[homeland]" name="registration[child_attributes[homeland]]"><option></option> <option value="Nederland">Nederland</option> <option value="België">België</option> <option value="Duitsland">Duitsland</option> <option value="Land Onbekend">Land Onbekend</option><option value="" disabled="disabled">-------------</option> <option value="Afghanistan">Afghanistan</option> <option value="Albanië">Albanië</option> <option value="Algerije">Algerije</option> <option value="Amerikaans-Samoa">Amerikaans-Samoa</option> <option value="Amerikaanse Maagdeneilanden">Amerikaanse Maagdeneilanden</option> <option value="Andorra">Andorra</option> <option value="Angola">Angola</option> <option value="Anguilla">Anguilla</option> <option value="Antarctica">Antarctica</option> <option value="Antigua en Barbuda">Antigua en Barbuda</option> <option value="Argentinië">Argentinië</option> <option value="Armenië">Armenië</option> <option value="Aruba">Aruba</option> <option value="Australië">Australië</option> <option value="Azerbeidzjan">Azerbeidzjan</option> <option value="Bahama’s">Bahama’s</option> <option value="Bahrein">Bahrein</option> <option value="Bangladesh">Bangladesh</option> <option value="Barbados">Barbados</option> <option value="België">België</option> <option value="Belize">Belize</option> <option value="Benin">Benin</option> <option value="Bermuda">Bermuda</option> <option value="Bhutan">Bhutan</option> <option value="Bolivia">Bolivia</option> <option value="Bosnië en Herzegovina">Bosnië en Herzegovina</option> <option value="Botswana">Botswana</option> <option value="Bouveteiland">Bouveteiland</option> <option value="Brazilië">Brazilië</option> <option value="Britse Gebieden in de Indische Oceaan">Britse Gebieden in de Indische Oceaan</option> <option value="Britse Maagdeneilanden">Britse Maagdeneilanden</option> <option value="Brunei">Brunei</option> <option value="Bulgarije">Bulgarije</option> <option value="Burkina Faso">Burkina Faso</option> <option value="Burundi">Burundi</option> <option value="Cambodja">Cambodja</option> <option value="Canada">Canada</option> <option value="Caribisch Nederland">Caribisch Nederland</option> <option value="Caymaneilanden">Caymaneilanden</option> <option value="Centraal-Afrikaanse Republiek">Centraal-Afrikaanse Republiek</option> <option value="Chili">Chili</option> <option value="China">China</option> <option value="Christmaseiland">Christmaseiland</option> <option value="Cocoseilanden">Cocoseilanden</option> <option value="Colombia">Colombia</option> <option value="Comoren">Comoren</option> <option value="Congo-Brazzaville">Congo-Brazzaville</option> <option value="Cookeilanden">Cookeilanden</option> <option value="Costa Rica">Costa Rica</option> <option value="Cuba">Cuba</option> <option value="Curaçao">Curaçao</option> <option value="Cyprus">Cyprus</option> <option value="Denemarken">Denemarken</option> <option value="Djibouti">Djibouti</option> <option value="Dominica">Dominica</option> <option value="Dominicaanse Republiek">Dominicaanse Republiek</option> <option value="Duitsland">Duitsland</option> <option value="Ecuador">Ecuador</option> <option value="Egypte">Egypte</option> <option value="El Salvador">El Salvador</option> <option value="Equatoriaal-Guinea">Equatoriaal-Guinea</option> <option value="Eritrea">Eritrea</option> <option value="Estland">Estland</option> <option value="Ethiopië">Ethiopië</option> <option value="Faeröer">Faeröer</option> <option value="Falklandeilanden">Falklandeilanden</option> <option value="Fiji">Fiji</option> <option value="Filipijnen">Filipijnen</option> <option value="Finland">Finland</option> <option value="Frankrijk">Frankrijk</option> <option value="Frans-Guyana">Frans-Guyana</option> <option value="Frans-Polynesië">Frans-Polynesië</option> <option value="Franse Gebieden in de zuidelijke Indische Oceaan">Franse Gebieden in de zuidelijke Indische Oceaan</option> <option value="Gabon">Gabon</option> <option value="Gambia">Gambia</option> <option value="Georgië">Georgië</option> <option value="Ghana">Ghana</option> <option value="Gibraltar">Gibraltar</option> <option value="Grenada">Grenada</option> <option value="Griekenland">Griekenland</option> <option value="Groenland">Groenland</option> <option value="Guadeloupe">Guadeloupe</option> <option value="Guam">Guam</option> <option value="Guatemala">Guatemala</option> <option value="Guinee">Guinee</option> <option value="Guinee-Bissau">Guinee-Bissau</option> <option value="Guyana">Guyana</option> <option value="Haïti">Haïti</option> <option value="Heard en McDonaldeilanden">Heard en McDonaldeilanden</option> <option value="Honduras">Honduras</option> <option value="Hongarije">Hongarije</option> <option value="Hongkong SAR van China">Hongkong SAR van China</option> <option value="IJsland">IJsland</option> <option value="Ierland">Ierland</option> <option value="India">India</option> <option value="Indonesië">Indonesië</option> <option value="Irak">Irak</option> <option value="Iran">Iran</option> <option value="Israël">Israël</option> <option value="Italië">Italië</option> <option value="Ivoorkust">Ivoorkust</option> <option value="Jamaica">Jamaica</option> <option value="Japan">Japan</option> <option value="Jemen">Jemen</option> <option value="Jordanië">Jordanië</option> <option value="Kaapverdië">Kaapverdië</option> <option value="Kameroen">Kameroen</option> <option value="Kazachstan">Kazachstan</option> <option value="Kenia">Kenia</option> <option value="Kirgizië">Kirgizië</option> <option value="Kiribati">Kiribati</option> <option value="Kleine afgelegen eilanden van de Verenigde Staten">Kleine afgelegen eilanden van de Verenigde Staten</option> <option value="Koeweit">Koeweit</option> <option value="Kroatië">Kroatië</option> <option value="Laos">Laos</option> <option value="Lesotho">Lesotho</option> <option value="Letland">Letland</option> <option value="Libanon">Libanon</option> <option value="Liberia">Liberia</option> <option value="Libië">Libië</option> <option value="Liechtenstein">Liechtenstein</option> <option value="Litouwen">Litouwen</option> <option value="Luxemburg">Luxemburg</option> <option value="Macau SAR van China">Macau SAR van China</option> <option value="Macedonië">Macedonië</option> <option value="Madagaskar">Madagaskar</option> <option value="Malawi">Malawi</option> <option value="Maldiven">Maldiven</option> <option value="Maleisië">Maleisië</option> <option value="Mali">Mali</option> <option value="Malta">Malta</option> <option value="Marokko">Marokko</option> <option value="Marshalleilanden">Marshalleilanden</option> <option value="Martinique">Martinique</option> <option value="Mauritanië">Mauritanië</option> <option value="Mauritius">Mauritius</option> <option value="Mexico">Mexico</option> <option value="Micronesia">Micronesia</option> <option value="Moldavië">Moldavië</option> <option value="Monaco">Monaco</option> <option value="Mongolië">Mongolië</option> <option value="Montserrat">Montserrat</option> <option value="Mozambique">Mozambique</option> <option value="Myanmar (Birma)">Myanmar (Birma)</option> <option value="Namibië">Namibië</option> <option value="Nauru">Nauru</option> <option value="Nederland">Nederland</option> <option value="Nepal">Nepal</option> <option value="Nicaragua">Nicaragua</option> <option value="Nieuw-Caledonië">Nieuw-Caledonië</option> <option value="Nieuw-Zeeland">Nieuw-Zeeland</option> <option value="Niger">Niger</option> <option value="Nigeria">Nigeria</option> <option value="Niue">Niue</option> <option value="Noord-Korea">Noord-Korea</option> <option value="Noordelijke Marianen">Noordelijke Marianen</option> <option value="Noorwegen">Noorwegen</option> <option value="Norfolk">Norfolk</option> <option value="Oeganda">Oeganda</option> <option value="Oekraïne">Oekraïne</option> <option value="Oezbekistan">Oezbekistan</option> <option value="Oman">Oman</option> <option value="Oostenrijk">Oostenrijk</option> <option value="Pakistan">Pakistan</option> <option value="Palau">Palau</option> <option value="Panama">Panama</option> <option value="Papoea-Nieuw-Guinea">Papoea-Nieuw-Guinea</option> <option value="Paraguay">Paraguay</option> <option value="Peru">Peru</option> <option value="Pitcairneilanden">Pitcairneilanden</option> <option value="Polen">Polen</option> <option value="Portugal">Portugal</option> <option value="Puerto Rico">Puerto Rico</option> <option value="Qatar">Qatar</option> <option value="Réunion">Réunion</option> <option value="Roemenië">Roemenië</option> <option value="Rusland">Rusland</option> <option value="Rwanda">Rwanda</option> <option value="Saint Kitts en Nevis">Saint Kitts en Nevis</option> <option value="Saint Lucia">Saint Lucia</option> <option value="Saint Vincent en de Grenadines">Saint Vincent en de Grenadines</option> <option value="Saint-Pierre en Miquelon">Saint-Pierre en Miquelon</option> <option value="Salomonseilanden">Salomonseilanden</option> <option value="Samoa">Samoa</option> <option value="San Marino">San Marino</option> <option value="Sao Tomé en Principe">Sao Tomé en Principe</option> <option value="Saoedi-Arabië">Saoedi-Arabië</option> <option value="Senegal">Senegal</option> <option value="Servië">Servië</option> <option value="Seychellen">Seychellen</option> <option value="Sierra Leone">Sierra Leone</option> <option value="Singapore">Singapore</option> <option value="Sint-Helena">Sint-Helena</option> <option value="Sint-Maarten">Sint-Maarten</option> <option value="Slovenië">Slovenië</option> <option value="Slowakije">Slowakije</option> <option value="Soedan">Soedan</option> <option value="Somalië">Somalië</option> <option value="Spanje">Spanje</option> <option value="Spitsbergen en Jan Mayen">Spitsbergen en Jan Mayen</option> <option value="Sri Lanka">Sri Lanka</option> <option value="Suriname">Suriname</option> <option value="Swaziland">Swaziland</option> <option value="Syrië">Syrië</option> <option value="Tadzjikistan">Tadzjikistan</option> <option value="Taiwan">Taiwan</option> <option value="Tanzania">Tanzania</option> <option value="Thailand">Thailand</option> <option value="Togo">Togo</option> <option value="Tokelau">Tokelau</option> <option value="Tonga">Tonga</option> <option value="Trinidad en Tobago">Trinidad en Tobago</option> <option value="Tsjaad">Tsjaad</option> <option value="Tsjechië">Tsjechië</option> <option value="Tunesië">Tunesië</option> <option value="Turkije">Turkije</option> <option value="Turkmenistan">Turkmenistan</option> <option value="Turks- en Caicoseilanden">Turks- en Caicoseilanden</option> <option value="Tuvalu">Tuvalu</option> <option value="Uruguay">Uruguay</option> <option value="Vanuatu">Vanuatu</option> <option value="Vaticaanstad">Vaticaanstad</option> <option value="Venezuela">Venezuela</option> <option value="Verenigd Koninkrijk">Verenigd Koninkrijk</option> <option value="Verenigde Arabische Emiraten">Verenigde Arabische Emiraten</option> <option value="Verenigde Staten">Verenigde Staten</option> <option value="Vietnam">Vietnam</option> <option value="Wallis en Futuna">Wallis en Futuna</option> <option value="Westelijke Sahara">Westelijke Sahara</option> <option value="Wit-Rusland">Wit-Rusland</option> <option value="Zambia">Zambia</option> <option value="Zimbabwe">Zimbabwe</option> <option value="Zuid-Afrika">Zuid-Afrika</option> <option value="Zuid-Korea">Zuid-Korea</option> <option value="Zuid-Soedan">Zuid-Soedan</option> <option value="Zweden">Zweden</option> <option value="Zwitserland">Zwitserland</option></select> <p class='inline-errors'></p> </li> <li class="string input optional stringish" id="registration_child_attributes_nationality_input"><label class=" label" for="registration_child_attributes_nationality">Nationaliteit</label><input id="registration_child_attributes_nationality" maxlength="255" name="registration[child_attributes][nationality]" type="text" /> </li> <li class="string input optional stringish" id="registration_child_attributes_language_input"><label class=" label" for="registration_child_attributes_language">Spreektaal</label><input id="registration_child_attributes_language" maxlength="255" name="registration[child_attributes][language]" type="text" /> </li> <li class="string input optional stringish" id="registration_child_attributes_religion_input"><label class=" label" for="registration_child_attributes_religion">Geloofsovertuiging</label><input id="registration_child_attributes_religion" maxlength="255" name="registration[child_attributes][religion]" type="text" /> </li> <li class="select input optional" id="registration_child_attributes_gender_input"><label class=" label" for="registration_child_attributes_gender">Geslacht</label><select id="registration_child_attributes_gender" name="registration[child_attributes][gender]"><option value=""></option> <option value="M">man</option> <option value="V">vrouw</option> <option value="N">neutraal</option> <option value="-">nog onbekend</option></select> </li> <li class="string input optional stringish" id="registration_child_attributes_bsnr_input"><label class=" label" for="registration_child_attributes_bsnr">Burgerservicenr</label><input id="registration_child_attributes_bsnr" maxlength="9" name="registration[child_attributes][bsnr]" type="text" /> </li> </ol></fieldset><fieldset class="inputs"><ol><li class="string input optional stringish" id="registration_child_attributes_nickname_input"><label class=" label" for="registration_child_attributes_nickname">Roepnaam</label><input id="registration_child_attributes_nickname" maxlength="255" name="registration[child_attributes][nickname]" type="text" /> </li> <li class="text input optional" id="registration_child_attributes_allergy_notes_input"><label class=" label" for="registration_child_attributes_allergy_notes">Allergie</label><textarea id="registration_child_attributes_allergy_notes" name="registration[child_attributes][allergy_notes]" rows="20"> </textarea> </li> <li class="text input optional" id="registration_child_attributes_drugs_notes_input"><label class=" label" for="registration_child_attributes_drugs_notes">Medicatie</label><textarea id="registration_child_attributes_drugs_notes" name="registration[child_attributes][drugs_notes]" rows="20"> </textarea> </li> <li class="text input optional" id="registration_child_attributes_drugs_notes_input"><label class=" label" for="registration_child_attributes_drugs_notes">Medische gegevens</label><textarea id="registration_child_attributes_drugs_notes" name="registration[child_attributes][drugs_notes]" rows="20"> </textarea> </li> <li class="text input optional" id="registration_child_attributes_vaccination_notes_input"><label class=" label" for="registration_child_attributes_vaccination_notes">Inentingen</label><textarea id="registration_child_attributes_vaccination_notes" name="registration[child_attributes][vaccination_notes]" rows="20"> </textarea> </li> <li class="string input optional stringish" id="registration_child_attributes_health_insurance_input"><label class=" label" for="registration_child_attributes_health_insurance">Zorgverzekering</label><input id="registration_child_attributes_health_insurance" maxlength="60" name="registration[child_attributes][health_insurance]" type="text" /> </li> <li class="string input optional stringish" id="registration_child_attributes_health_insurance_policy_number_input"><label class=" label" for="registration_child_attributes_health_insurance_policy_number">Polisnummer</label><input id="registration_child_attributes_health_insurance_policy_number" maxlength="60" name="registration[child_attributes][health_insurance_policy_number]" type="text" /> </li> <li class="string input optional stringish" id="registration_child_attributes_pickup_person_name_input"><label class=" label" for="registration_child_attributes_pickup_person_name">Mag opgehaald worden door</label><input id="registration_child_attributes_pickup_person_name" maxlength="255" name="registration[child_attributes][pickup_person_name]" type="text" /> </li> </ol></fieldset><fieldset class="inputs"><ol><li class="select input optional" id="registration_child_attributes_doctor_input"><label class=" label" for="registration_child_attributes_doctor_id">Huisarts</label><select id="registration_child_attributes_doctor_id" name="registration[child_attributes][doctor_id]"><option value=""></option> <option value="579362">dhr Kangangi, </option> <option value="578898">dhr Quadekker, </option> <option value="578918">Dr. Kamphoven, </option> <option value="844678">Dr. Muskee, </option> <option value="834958">dr Nieuwhof, </option> <option value="237925">Dr. Schueler, </option> <option value="579326">Dr. Smulders , </option> <option value="578901">Dr Valkenburg en Dr Oudraad, </option> <option value="579284">Dr van Herwerden, </option> <option value="578897">Goyaarts, </option> <option value="428846">H.A.P., </option> <option value="579197">Heyboer, </option> <option value="834957">Huisartsen praktijk Hoge vucht, </option> <option value="579400">huisartsenpraktijk Riel, </option> <option value="832017">Hurk, </option> <option value="831136">Majdandzic, </option> <option value="579713">Saes, Perree & Leemans, </option> <option value="579916">van Dijk, </option> <option value="428903">van Eerd, </option> <option value="428885">Van Valkenburg-aa, </option> <option value="830887">Van Walsum, </option> <option value="832674">Waale, </option> <option value="840074">Zomra huisartspraktijk, </option></select> </li> <li class="select input optional" id="registration_child_attributes_dentist_input"><label class=" label" for="registration_child_attributes_dentist_id">Tandarts</label><select id="registration_child_attributes_dentist_id" name="registration[child_attributes][dentist_id]"><option value=""></option> <option value="578899">Dudok, </option> <option value="579416">groepspraktijk De Besterd, </option> <option value="428904">Kriele, </option> <option value="579363">Manie, </option> <option value="428886">Pino, </option> <option value="428847">Reede van Asselt, </option> <option value="840075">tandartsenpraktijk Nijverheidssingel , </option> <option value="844679">Tandartspraktijk Rietveld Teteringen, </option> <option value="578919">Tielemans, </option> <option value="579327">Vroegh en Yoe , </option></select> </li> <li> <p class='inline-hints'>Als uw huisarts of tandarts niet vermeld wordt, wilt u dan de naam vermelden bovenaan bij de toelichting?</p> </li> </ol></fieldset> </div> <div class='form_group' id='parent'> <h3 class='registration'>Toestemmingen</h3> <h4>Selecteer wat van toepassing is.</h4> <fieldset class="inputs"><ol><li> <li class="select input required" id="registration_consent_13011_input"><label class=" label" for="registration_consent_13011">Mag uw kind mee met de bus en auto van Bloem?<abbr title="required">*</abbr></label><select class="consent-required" id="registration_consent_13011" name="registration[consent][13011]"><option value=""></option> <option value="Ja">Ja</option> <option value="Nee">Nee</option></select> </li> </li> <li> <li class="select input required" id="registration_consent_13012_input"><label class=" label" for="registration_consent_13012">Neemt uw kind deel aan het inentingsprogramma?<abbr title="required">*</abbr></label><select class="consent-required" id="registration_consent_13012" name="registration[consent][13012]"><option value=""></option> <option value="Ja">Ja</option> <option value="Nee">Nee</option></select> </li> </li> <li> <li class="select input required" id="registration_consent_13013_input"><label class=" label" for="registration_consent_13013">Mogen er binnen het kinderdagverblijf foto's van uw kind gemaakt worden voor intern gebruik?<abbr title="required">*</abbr></label><select class="consent-required" id="registration_consent_13013" name="registration[consent][13013]"><option value=""></option> <option value="Ja">Ja</option> <option value="Nee">Nee</option></select> </li> </li> <li> <li class="select input required" id="registration_consent_13014_input"><label class=" label" for="registration_consent_13014">Mag uw kind met foto's (zonder naam) op onze socials (FB/instagram)?<abbr title="required">*</abbr></label><select class="consent-required" id="registration_consent_13014" name="registration[consent][13014]"><option value=""></option> <option value="Ja">Ja</option> <option value="Nee">Nee</option></select> </li> </li> <li> <li class="select input required" id="registration_consent_13015_input"><label class=" label" for="registration_consent_13015">Mag uw kind met foto's van de rug (zonder naam) op onze socials (FB/instagram)?<abbr title="required">*</abbr></label><select class="consent-required" id="registration_consent_13015" name="registration[consent][13015]"><option value=""></option> <option value="Ja">Ja</option> <option value="Nee">Nee</option></select> </li> </li> <li> <li class="select input required" id="registration_consent_13016_input"><label class=" label" for="registration_consent_13016">Mag uw kind af en toe in een andere groep spelen dan de stamgroep? (bijv. bij ruildagen)<abbr title="required">*</abbr></label><select class="consent-required" id="registration_consent_13016" name="registration[consent][13016]"><option value=""></option> <option value="Ja">Ja</option> <option value="Nee">Nee</option></select> </li> </li> <li> <li class="select input required" id="registration_consent_13017_input"><label class=" label" for="registration_consent_13017">Heeft u interesse om deel te nemen aan de oudercommissie?<abbr title="required">*</abbr></label><select class="consent-required" id="registration_consent_13017" name="registration[consent][13017]"><option value=""></option> <option value="Ja">Ja</option> <option value="Nee">Nee</option></select> </li> </li> <li> <li class="select input required" id="registration_consent_13018_input"><label class=" label" for="registration_consent_13018">Wilt u informatie over de oudercommissie ontvangen via de mail?<abbr title="required">*</abbr></label><select class="consent-required" id="registration_consent_13018" name="registration[consent][13018]"><option value=""></option> <option value="Ja">Ja</option> <option value="Nee">Nee</option></select> </li> </li> <li> <li class="select input required" id="registration_consent_13454_input"><label class=" label" for="registration_consent_13454">Ik heb het document toelichting video gebruik binnen bloem gelezen en ik geef toestemming dat het beeldmateriaal van mijn kind voor dit doeleind gebruik mag worden.<abbr title="required">*</abbr></label><select class="consent-required" id="registration_consent_13454" name="registration[consent][13454]"><option value=""></option> <option value="Ja">Ja</option> <option value="Nee">Nee</option></select> </li> </li> </ol></fieldset> </div> <div class='form_group' id='parent'> <h3 class='registration'>Ouder/verzorger 1 (Waar de rekening naar gestuurd wordt.)</h3> <fieldset class="inputs"><ol><li class="string input required stringish" id="registration_parents_attributes_title_1_input"><label class=" label" for="registration_parents_attributes_title_1">Aanhef<abbr title="required">*</abbr></label><input id="registration_parents_attributes_title_1" maxlength="10" name="registration[parents_attributes][title_1]" size="10" type="text" /> </li> <li class="string input required stringish" id="registration_parents_attributes_initials_1_input"><label class=" label" for="registration_parents_attributes_initials_1">Initialen<abbr title="required">*</abbr></label><input id="registration_parents_attributes_initials_1" maxlength="10" name="registration[parents_attributes][initials_1]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_firstname_1_input"><label class=" label" for="registration_parents_attributes_firstname_1">Voornaam</label><input id="registration_parents_attributes_firstname_1" maxlength="60" name="registration[parents_attributes][firstname_1]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_in_between_first_and_lastname_1_input"><label class=" label" for="registration_parents_attributes_in_between_first_and_lastname_1">Tussenvoegsel</label><input id="registration_parents_attributes_in_between_first_and_lastname_1" maxlength="10" name="registration[parents_attributes][in_between_first_and_lastname_1]" size="10" type="text" /> </li> <li class="string input required stringish" id="registration_parents_attributes_lastname_1_input"><label class=" label" for="registration_parents_attributes_lastname_1">Achternaam<abbr title="required">*</abbr></label><input id="registration_parents_attributes_lastname_1" maxlength="60" name="registration[parents_attributes][lastname_1]" type="text" /> </li> <li class="select input optional" id="registration_parents_attributes_function_1_input"><label class=" label" for="registration_parents_attributes_function_1">Relatie</label><select id="registration_parents_attributes_function_1" name="registration[parents_attributes][function_1]"><option value=""></option> <option value="father">Vader</option> <option value="mother">Moeder</option> <option value="stepparent">Stiefouder</option> <option value="bonusparent">Bonusouder</option> <option value="caretakers">Verzorger</option> <option value="grandfather">Opa/oma</option> <option value="contactperson">Contactpersoon</option> <option value="other">Overig</option></select> </li> <li class="string input required stringish" id="registration_parents_attributes_date_of_birth_1_input"><label class=" label" for="registration_parents_attributes_date_of_birth_1">Geboortedatum<abbr title="required">*</abbr></label><input id="registration_parents_attributes_date_of_birth_1" name="registration[parents_attributes][date_of_birth_1]" type="text" /> </li> <li class='input optional select' id='registration_parents_attributes_homeland_1_input'> <label class='label' for='registration_parents_attributes_homeland_1_input'> Geboorteland </label> <select id="registration_parents_attributes[homeland_1]" name="registration[parents_attributes[homeland_1]]"><option></option> <option value="Nederland">Nederland</option> <option value="België">België</option> <option value="Duitsland">Duitsland</option> <option value="Land Onbekend">Land Onbekend</option><option value="" disabled="disabled">-------------</option> <option value="Afghanistan">Afghanistan</option> <option value="Albanië">Albanië</option> <option value="Algerije">Algerije</option> <option value="Amerikaans-Samoa">Amerikaans-Samoa</option> <option value="Amerikaanse Maagdeneilanden">Amerikaanse Maagdeneilanden</option> <option value="Andorra">Andorra</option> <option value="Angola">Angola</option> <option value="Anguilla">Anguilla</option> <option value="Antarctica">Antarctica</option> <option value="Antigua en Barbuda">Antigua en Barbuda</option> <option value="Argentinië">Argentinië</option> <option value="Armenië">Armenië</option> <option value="Aruba">Aruba</option> <option value="Australië">Australië</option> <option value="Azerbeidzjan">Azerbeidzjan</option> <option value="Bahama’s">Bahama’s</option> <option value="Bahrein">Bahrein</option> <option value="Bangladesh">Bangladesh</option> <option value="Barbados">Barbados</option> <option value="België">België</option> <option value="Belize">Belize</option> <option value="Benin">Benin</option> <option value="Bermuda">Bermuda</option> <option value="Bhutan">Bhutan</option> <option value="Bolivia">Bolivia</option> <option value="Bosnië en Herzegovina">Bosnië en Herzegovina</option> <option value="Botswana">Botswana</option> <option value="Bouveteiland">Bouveteiland</option> <option value="Brazilië">Brazilië</option> <option value="Britse Gebieden in de Indische Oceaan">Britse Gebieden in de Indische Oceaan</option> <option value="Britse Maagdeneilanden">Britse Maagdeneilanden</option> <option value="Brunei">Brunei</option> <option value="Bulgarije">Bulgarije</option> <option value="Burkina Faso">Burkina Faso</option> <option value="Burundi">Burundi</option> <option value="Cambodja">Cambodja</option> <option value="Canada">Canada</option> <option value="Caribisch Nederland">Caribisch Nederland</option> <option value="Caymaneilanden">Caymaneilanden</option> <option value="Centraal-Afrikaanse Republiek">Centraal-Afrikaanse Republiek</option> <option value="Chili">Chili</option> <option value="China">China</option> <option value="Christmaseiland">Christmaseiland</option> <option value="Cocoseilanden">Cocoseilanden</option> <option value="Colombia">Colombia</option> <option value="Comoren">Comoren</option> <option value="Congo-Brazzaville">Congo-Brazzaville</option> <option value="Cookeilanden">Cookeilanden</option> <option value="Costa Rica">Costa Rica</option> <option value="Cuba">Cuba</option> <option value="Curaçao">Curaçao</option> <option value="Cyprus">Cyprus</option> <option value="Denemarken">Denemarken</option> <option value="Djibouti">Djibouti</option> <option value="Dominica">Dominica</option> <option value="Dominicaanse Republiek">Dominicaanse Republiek</option> <option value="Duitsland">Duitsland</option> <option value="Ecuador">Ecuador</option> <option value="Egypte">Egypte</option> <option value="El Salvador">El Salvador</option> <option value="Equatoriaal-Guinea">Equatoriaal-Guinea</option> <option value="Eritrea">Eritrea</option> <option value="Estland">Estland</option> <option value="Ethiopië">Ethiopië</option> <option value="Faeröer">Faeröer</option> <option value="Falklandeilanden">Falklandeilanden</option> <option value="Fiji">Fiji</option> <option value="Filipijnen">Filipijnen</option> <option value="Finland">Finland</option> <option value="Frankrijk">Frankrijk</option> <option value="Frans-Guyana">Frans-Guyana</option> <option value="Frans-Polynesië">Frans-Polynesië</option> <option value="Franse Gebieden in de zuidelijke Indische Oceaan">Franse Gebieden in de zuidelijke Indische Oceaan</option> <option value="Gabon">Gabon</option> <option value="Gambia">Gambia</option> <option value="Georgië">Georgië</option> <option value="Ghana">Ghana</option> <option value="Gibraltar">Gibraltar</option> <option value="Grenada">Grenada</option> <option value="Griekenland">Griekenland</option> <option value="Groenland">Groenland</option> <option value="Guadeloupe">Guadeloupe</option> <option value="Guam">Guam</option> <option value="Guatemala">Guatemala</option> <option value="Guinee">Guinee</option> <option value="Guinee-Bissau">Guinee-Bissau</option> <option value="Guyana">Guyana</option> <option value="Haïti">Haïti</option> <option value="Heard en McDonaldeilanden">Heard en McDonaldeilanden</option> <option value="Honduras">Honduras</option> <option value="Hongarije">Hongarije</option> <option value="Hongkong SAR van China">Hongkong SAR van China</option> <option value="IJsland">IJsland</option> <option value="Ierland">Ierland</option> <option value="India">India</option> <option value="Indonesië">Indonesië</option> <option value="Irak">Irak</option> <option value="Iran">Iran</option> <option value="Israël">Israël</option> <option value="Italië">Italië</option> <option value="Ivoorkust">Ivoorkust</option> <option value="Jamaica">Jamaica</option> <option value="Japan">Japan</option> <option value="Jemen">Jemen</option> <option value="Jordanië">Jordanië</option> <option value="Kaapverdië">Kaapverdië</option> <option value="Kameroen">Kameroen</option> <option value="Kazachstan">Kazachstan</option> <option value="Kenia">Kenia</option> <option value="Kirgizië">Kirgizië</option> <option value="Kiribati">Kiribati</option> <option value="Kleine afgelegen eilanden van de Verenigde Staten">Kleine afgelegen eilanden van de Verenigde Staten</option> <option value="Koeweit">Koeweit</option> <option value="Kroatië">Kroatië</option> <option value="Laos">Laos</option> <option value="Lesotho">Lesotho</option> <option value="Letland">Letland</option> <option value="Libanon">Libanon</option> <option value="Liberia">Liberia</option> <option value="Libië">Libië</option> <option value="Liechtenstein">Liechtenstein</option> <option value="Litouwen">Litouwen</option> <option value="Luxemburg">Luxemburg</option> <option value="Macau SAR van China">Macau SAR van China</option> <option value="Macedonië">Macedonië</option> <option value="Madagaskar">Madagaskar</option> <option value="Malawi">Malawi</option> <option value="Maldiven">Maldiven</option> <option value="Maleisië">Maleisië</option> <option value="Mali">Mali</option> <option value="Malta">Malta</option> <option value="Marokko">Marokko</option> <option value="Marshalleilanden">Marshalleilanden</option> <option value="Martinique">Martinique</option> <option value="Mauritanië">Mauritanië</option> <option value="Mauritius">Mauritius</option> <option value="Mexico">Mexico</option> <option value="Micronesia">Micronesia</option> <option value="Moldavië">Moldavië</option> <option value="Monaco">Monaco</option> <option value="Mongolië">Mongolië</option> <option value="Montserrat">Montserrat</option> <option value="Mozambique">Mozambique</option> <option value="Myanmar (Birma)">Myanmar (Birma)</option> <option value="Namibië">Namibië</option> <option value="Nauru">Nauru</option> <option value="Nederland">Nederland</option> <option value="Nepal">Nepal</option> <option value="Nicaragua">Nicaragua</option> <option value="Nieuw-Caledonië">Nieuw-Caledonië</option> <option value="Nieuw-Zeeland">Nieuw-Zeeland</option> <option value="Niger">Niger</option> <option value="Nigeria">Nigeria</option> <option value="Niue">Niue</option> <option value="Noord-Korea">Noord-Korea</option> <option value="Noordelijke Marianen">Noordelijke Marianen</option> <option value="Noorwegen">Noorwegen</option> <option value="Norfolk">Norfolk</option> <option value="Oeganda">Oeganda</option> <option value="Oekraïne">Oekraïne</option> <option value="Oezbekistan">Oezbekistan</option> <option value="Oman">Oman</option> <option value="Oostenrijk">Oostenrijk</option> <option value="Pakistan">Pakistan</option> <option value="Palau">Palau</option> <option value="Panama">Panama</option> <option value="Papoea-Nieuw-Guinea">Papoea-Nieuw-Guinea</option> <option value="Paraguay">Paraguay</option> <option value="Peru">Peru</option> <option value="Pitcairneilanden">Pitcairneilanden</option> <option value="Polen">Polen</option> <option value="Portugal">Portugal</option> <option value="Puerto Rico">Puerto Rico</option> <option value="Qatar">Qatar</option> <option value="Réunion">Réunion</option> <option value="Roemenië">Roemenië</option> <option value="Rusland">Rusland</option> <option value="Rwanda">Rwanda</option> <option value="Saint Kitts en Nevis">Saint Kitts en Nevis</option> <option value="Saint Lucia">Saint Lucia</option> <option value="Saint Vincent en de Grenadines">Saint Vincent en de Grenadines</option> <option value="Saint-Pierre en Miquelon">Saint-Pierre en Miquelon</option> <option value="Salomonseilanden">Salomonseilanden</option> <option value="Samoa">Samoa</option> <option value="San Marino">San Marino</option> <option value="Sao Tomé en Principe">Sao Tomé en Principe</option> <option value="Saoedi-Arabië">Saoedi-Arabië</option> <option value="Senegal">Senegal</option> <option value="Servië">Servië</option> <option value="Seychellen">Seychellen</option> <option value="Sierra Leone">Sierra Leone</option> <option value="Singapore">Singapore</option> <option value="Sint-Helena">Sint-Helena</option> <option value="Sint-Maarten">Sint-Maarten</option> <option value="Slovenië">Slovenië</option> <option value="Slowakije">Slowakije</option> <option value="Soedan">Soedan</option> <option value="Somalië">Somalië</option> <option value="Spanje">Spanje</option> <option value="Spitsbergen en Jan Mayen">Spitsbergen en Jan Mayen</option> <option value="Sri Lanka">Sri Lanka</option> <option value="Suriname">Suriname</option> <option value="Swaziland">Swaziland</option> <option value="Syrië">Syrië</option> <option value="Tadzjikistan">Tadzjikistan</option> <option value="Taiwan">Taiwan</option> <option value="Tanzania">Tanzania</option> <option value="Thailand">Thailand</option> <option value="Togo">Togo</option> <option value="Tokelau">Tokelau</option> <option value="Tonga">Tonga</option> <option value="Trinidad en Tobago">Trinidad en Tobago</option> <option value="Tsjaad">Tsjaad</option> <option value="Tsjechië">Tsjechië</option> <option value="Tunesië">Tunesië</option> <option value="Turkije">Turkije</option> <option value="Turkmenistan">Turkmenistan</option> <option value="Turks- en Caicoseilanden">Turks- en Caicoseilanden</option> <option value="Tuvalu">Tuvalu</option> <option value="Uruguay">Uruguay</option> <option value="Vanuatu">Vanuatu</option> <option value="Vaticaanstad">Vaticaanstad</option> <option value="Venezuela">Venezuela</option> <option value="Verenigd Koninkrijk">Verenigd Koninkrijk</option> <option value="Verenigde Arabische Emiraten">Verenigde Arabische Emiraten</option> <option value="Verenigde Staten">Verenigde Staten</option> <option value="Vietnam">Vietnam</option> <option value="Wallis en Futuna">Wallis en Futuna</option> <option value="Westelijke Sahara">Westelijke Sahara</option> <option value="Wit-Rusland">Wit-Rusland</option> <option value="Zambia">Zambia</option> <option value="Zimbabwe">Zimbabwe</option> <option value="Zuid-Afrika">Zuid-Afrika</option> <option value="Zuid-Korea">Zuid-Korea</option> <option value="Zuid-Soedan">Zuid-Soedan</option> <option value="Zweden">Zweden</option> <option value="Zwitserland">Zwitserland</option></select> <p class='inline-errors'></p> </li> <li class="string input optional stringish" id="registration_parents_attributes_nationality_1_input"><label class=" label" for="registration_parents_attributes_nationality_1">Nationaliteit</label><input id="registration_parents_attributes_nationality_1" maxlength="255" name="registration[parents_attributes][nationality_1]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_language_1_input"><label class=" label" for="registration_parents_attributes_language_1">Spreektaal</label><input id="registration_parents_attributes_language_1" maxlength="255" name="registration[parents_attributes][language_1]" type="text" /> </li> <li class="string input required stringish" id="registration_parents_attributes_bsnr_1_input"><label class=" label" for="registration_parents_attributes_bsnr_1">Burgerservicenr<abbr title="required">*</abbr></label><input id="registration_parents_attributes_bsnr_1" maxlength="9" name="registration[parents_attributes][bsnr_1]" size="9" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_education_level_1_input"><label class=" label" for="registration_parents_attributes_education_level_1">Hoogst genoten opleiding</label><input id="registration_parents_attributes_education_level_1" maxlength="60" name="registration[parents_attributes][education_level_1]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_profession_1_input"><label class=" label" for="registration_parents_attributes_profession_1">Beroep</label><input id="registration_parents_attributes_profession_1" maxlength="255" name="registration[parents_attributes][profession_1]" type="text" /> </li> <li class='input optional string' id='registration_parents_attributes_referred_to_vve_input'> <label class='label' for='registration_parents_attributes_referred_to_vve'> Doorverwezen voor VVE-plaatsing </label> <input name="registration[parents_attributes][referred_to_vve]" type="hidden" value="0" /><input id="registration_parents_attributes_referred_to_vve" name="registration[parents_attributes][referred_to_vve]" type="checkbox" value="1" /> <p class='inline-errors'></p> </li> <li class="select input optional" id="registration_parents_attributes_personal_situation_input"><label class=" label" for="registration_parents_attributes_personal_situation">Persoonlijke situatie</label><select id="registration_parents_attributes_personal_situation" name="registration[parents_attributes][personal_situation]"><option value=""></option> <option value="U woont samen en bent beide werkzaam">U woont samen en bent beide werkzaam</option> <option value="U woont alleen en u bent werkzaam">U woont alleen en u bent werkzaam</option> <option value="U woont samen en één partner is niet werkzaam">U woont samen en één partner is niet werkzaam</option> <option value="U woont samen en beide partners zijn niet werkzaam">U woont samen en beide partners zijn niet werkzaam</option> <option value="U bent alleen en niet werkzaam">U bent alleen en niet werkzaam</option></select> </li> <li class="select input optional" id="registration_parents_attributes_jointly_income_input" style="display:none;"><label class=" label" for="registration_parents_attributes_jointly_income">Gezamenlijk inkomen</label><select id="registration_parents_attributes_jointly_income" name="registration[parents_attributes][jointly_income]"><option value=""></option> <option value="minder dan € 21.278">minder dan € 21.278</option> <option value="€ 21.279 t/m € 22.695">€ 21.279 t/m € 22.695</option> <option value="€ 22.696 t/m € 24.110">€ 22.696 t/m € 24.110</option> <option value="€ 24.111 t/m € 25.528">€ 24.111 t/m € 25.528</option> <option value="€ 25.529 t/m € 26.944">€ 25.529 t/m € 26.944</option> <option value="€ 26.945 t/m € 28.362">€ 26.945 t/m € 28.362</option> <option value="€ 28.363 t/m € 29.778">€ 28.363 t/m € 29.778</option> <option value="€ 29.779 t/m € 31.191">€ 29.779 t/m € 31.191</option> <option value="€ 31.192 t/m € 32.715">€ 31.192 t/m € 32.715</option> <option value="€ 32.716 t/m € 34.236">€ 32.716 t/m € 34.236</option> <option value="€ 34.237 t/m € 35.762">€ 34.237 t/m € 35.762</option> <option value="€ 35.763 t/m € 37.283">€ 35.763 t/m € 37.283</option> <option value="€ 37.284 t/m € 38.811">€ 37.284 t/m € 38.811</option> <option value="€ 38.812 t/m € 40.334">€ 38.812 t/m € 40.334</option> <option value="€ 40.335 t/m € 41.894">€ 40.335 t/m € 41.894</option> <option value="€ 41.895 t/m € 43.456">€ 41.895 t/m € 43.456</option> <option value="€ 43.457 t/m € 45.018">€ 43.457 t/m € 45.018</option> <option value="€ 45.019 t/m € 46.580">€ 45.019 t/m € 46.580</option> <option value="€ 46.581 t/m € 48.145">€ 46.581 t/m € 48.145</option> <option value="€ 48.146 t/m € 49.706">€ 48.146 t/m € 49.706</option> <option value="€ 49.707 t/m € 51.267">€ 49.707 t/m € 51.267</option> <option value="€ 51.268 t/m € 52.830">€ 51.268 t/m € 52.830</option> <option value="€ 52.831 t/m € 54.537">€ 52.831 t/m € 54.537</option> <option value="€ 54.538 t/m € 57.885">€ 54.538 t/m € 57.885</option> <option value="€ 57.886 t/m € 61.231">€ 57.886 t/m € 61.231</option> <option value="€ 61.232 t/m € 64.579">€ 61.232 t/m € 64.579</option> <option value="€ 64.580 t/m € 67.929">€ 64.580 t/m € 67.929</option> <option value="€ 67.930 t/m € 71.275">€ 67.930 t/m € 71.275</option> <option value="€ 71.276 t/m € 74.625">€ 71.276 t/m € 74.625</option> <option value="€ 74.626 t/m € 77.972">€ 74.626 t/m € 77.972</option> <option value="€ 77.973 t/m € 81.320">€ 77.973 t/m € 81.320</option> <option value="€ 81.321 t/m € 84.669">€ 81.321 t/m € 84.669</option> <option value="€ 84.670 t/m € 88.015">€ 84.670 t/m € 88.015</option> <option value="€ 88.016 t/m € 91.367">€ 88.016 t/m € 91.367</option> <option value="€ 91.368 t/m € 94.714">€ 91.368 t/m € 94.714</option> <option value="€ 94.715 t/m € 98.060">€ 94.715 t/m € 98.060</option> <option value="€ 98.061 t/m € 101.408">€ 98.061 t/m € 101.408</option> <option value="€ 101.409 t/m € 104.822">€ 101.409 t/m € 104.822</option> <option value="€ 104.823 t/m € 108.252">€ 104.823 t/m € 108.252</option> <option value="€ 108.253 t/m € 111.680">€ 108.253 t/m € 111.680</option> <option value="€ 111.681 t/m € 115.109">€ 111.681 t/m € 115.109</option> <option value="€ 115.110 t/m € 118.535">€ 115.110 t/m € 118.535</option> <option value="€ 118.536 t/m € 121.965">€ 118.536 t/m € 121.965</option> <option value="€ 121.966 t/m € 125.395">€ 121.966 t/m € 125.395</option> <option value="€ 125.396 t/m € 128.825">€ 125.396 t/m € 128.825</option> <option value="€ 128.826 t/m € 132.250">€ 128.826 t/m € 132.250</option> <option value="€ 132.251 t/m € 135.678">€ 132.251 t/m € 135.678</option> <option value="€ 135.679 t/m € 139.109">€ 135.679 t/m € 139.109</option> <option value="€ 139.110 t/m € 142.536">€ 139.110 t/m € 142.536</option> <option value="€ 142.537 t/m € 145.965">€ 142.537 t/m € 145.965</option> <option value="€ 145.966 t/m € 149.392">€ 145.966 t/m € 149.392</option> <option value="€ 149.393 t/m € 152.822">€ 149.393 t/m € 152.822</option> <option value="€ 152.823 t/m € 156.254">€ 152.823 t/m € 156.254</option> <option value="€ 156.255 t/m € 159.680">€ 156.255 t/m € 159.680</option> <option value="€ 159.681 t/m € 163.109">€ 159.681 t/m € 163.109</option> <option value="€ 163.110 t/m € 166.535">€ 163.110 t/m € 166.535</option> <option value="€ 166.536 t/m € 169.966">€ 166.536 t/m € 169.966</option> <option value="€ 169.967 t/m € 173.396">€ 169.967 t/m € 173.396</option> <option value="€ 173.397 t/m € 176.824">€ 173.397 t/m € 176.824</option> <option value="€ 176.825 t/m € 180.252">€ 176.825 t/m € 180.252</option> <option value="€ 180.253 t/m € 183.677">€ 180.253 t/m € 183.677</option> <option value="€ 183.678 t/m € 187.109">€ 183.678 t/m € 187.109</option> <option value="€ 187.110 t/m € 190.536">€ 187.110 t/m € 190.536</option> <option value="€ 190.537 t/m € 193.966">€ 190.537 t/m € 193.966</option> <option value="€ 193.967 t/m € 197.395">€ 193.967 t/m € 197.395</option> <option value="€ 197.396 t/m € 200.822">€ 197.396 t/m € 200.822</option> <option value="€ 200.823 t/m € 204.252">€ 200.823 t/m € 204.252</option> <option value="€ 204.253 t/m € 207.679">€ 204.253 t/m € 207.679</option> <option value="€ 207.680 of meer">€ 207.680 of meer</option></select> </li> <li class="string input required stringish" id="registration_parents_attributes_street_1_input"><label class=" label" for="registration_parents_attributes_street_1">Straat<abbr title="required">*</abbr></label><input id="registration_parents_attributes_street_1" maxlength="60" name="registration[parents_attributes][street_1]" type="text" /> </li> <li class="string input required stringish" id="registration_parents_attributes_number_1_input"><label class=" label" for="registration_parents_attributes_number_1">Huisnummer<abbr title="required">*</abbr></label><input id="registration_parents_attributes_number_1" maxlength="10" name="registration[parents_attributes][number_1]" size="10" type="text" /> </li> <li class="string input required stringish" id="registration_parents_attributes_postcode_nrs_1_input"><label class=" label" for="registration_parents_attributes_postcode_nrs_1">Postcode nr<abbr title="required">*</abbr></label><input id="registration_parents_attributes_postcode_nrs_1" maxlength="5" name="registration[parents_attributes][postcode_nrs_1]" type="text" /> </li> <li class="string input required stringish" id="registration_parents_attributes_postcode_chars_1_input"><label class=" label" for="registration_parents_attributes_postcode_chars_1">Postcode (ltrs)<abbr title="required">*</abbr></label><input id="registration_parents_attributes_postcode_chars_1" maxlength="2" name="registration[parents_attributes][postcode_chars_1]" size="2" style="text-transform: uppercase;" type="text" /> </li> <li class="string input required stringish" id="registration_parents_attributes_city_1_input"><label class=" label" for="registration_parents_attributes_city_1">Woonplaats<abbr title="required">*</abbr></label><input id="registration_parents_attributes_city_1" maxlength="60" name="registration[parents_attributes][city_1]" type="text" /> </li> <li class="string input required stringish" id="registration_parents_attributes_phone_1_input"><label class=" label" for="registration_parents_attributes_phone_1">Telefoon (thuis)<abbr title="required">*</abbr></label><input id="registration_parents_attributes_phone_1" maxlength="255" name="registration[parents_attributes][phone_1]" type="text" /> </li> <li class="string input required stringish" id="registration_parents_attributes_mobile_1_input"><label class=" label" for="registration_parents_attributes_mobile_1">Telefoon (mobiel)<abbr title="required">*</abbr></label><input id="registration_parents_attributes_mobile_1" maxlength="255" name="registration[parents_attributes][mobile_1]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_work_phone_1_input"><label class=" label" for="registration_parents_attributes_work_phone_1">Telefoon (werk)</label><input id="registration_parents_attributes_work_phone_1" maxlength="255" name="registration[parents_attributes][work_phone_1]" type="text" /> </li> <li class="email input required stringish" id="registration_parents_attributes_email_1_input"><label class=" label" for="registration_parents_attributes_email_1">Email<abbr title="required">*</abbr></label><input id="registration_parents_attributes_email_1" maxlength="60" name="registration[parents_attributes][email_1]" size="20" type="email" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_iban_1_input"><label class=" label" for="registration_parents_attributes_iban_1">IBAN nummer</label><input id="registration_parents_attributes_iban_1" maxlength="255" name="registration[parents_attributes][iban_1]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_bic_code_1_input"><label class=" label" for="registration_parents_attributes_bic_code_1">BIC code</label><input id="registration_parents_attributes_bic_code_1" maxlength="255" name="registration[parents_attributes][bic_code_1]" type="text" /> </li> <li class="hidden input optional" id="registration_parents_attributes_which_debtor_input"><input id="registration_parents_attributes_which_debtor" name="registration[parents_attributes][which_debtor]" type="hidden" value="1" /> </li> </ol></fieldset> </div> <div class='clear'></div> <div class='form_group' id='parent'> <h3 class='registration'>Ouder/verzorger 2</h3> <fieldset class="inputs"><ol><li class="string input optional stringish" id="registration_parents_attributes_title_2_input"><label class=" label" for="registration_parents_attributes_title_2">Aanhef</label><input id="registration_parents_attributes_title_2" maxlength="10" name="registration[parents_attributes][title_2]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_initials_2_input"><label class=" label" for="registration_parents_attributes_initials_2">Initialen</label><input id="registration_parents_attributes_initials_2" maxlength="10" name="registration[parents_attributes][initials_2]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_firstname_2_input"><label class=" label" for="registration_parents_attributes_firstname_2">Voornaam</label><input id="registration_parents_attributes_firstname_2" maxlength="60" name="registration[parents_attributes][firstname_2]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_in_between_first_and_lastname_2_input"><label class=" label" for="registration_parents_attributes_in_between_first_and_lastname_2">Tussenvoegsel</label><input id="registration_parents_attributes_in_between_first_and_lastname_2" maxlength="10" name="registration[parents_attributes][in_between_first_and_lastname_2]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_lastname_2_input"><label class=" label" for="registration_parents_attributes_lastname_2">Achternaam</label><input id="registration_parents_attributes_lastname_2" maxlength="60" name="registration[parents_attributes][lastname_2]" type="text" /> </li> <li class="select input optional" id="registration_parents_attributes_function_2_input"><label class=" label" for="registration_parents_attributes_function_2">Relatie</label><select id="registration_parents_attributes_function_2" name="registration[parents_attributes][function_2]"><option value=""></option> <option value="father">Vader</option> <option value="mother">Moeder</option> <option value="stepparent">Stiefouder</option> <option value="bonusparent">Bonusouder</option> <option value="caretakers">Verzorger</option> <option value="grandfather">Opa/oma</option> <option value="contactperson">Contactpersoon</option> <option value="other">Overig</option></select> </li> <li class="string input optional stringish" id="registration_parents_attributes_date_of_birth_2_input"><label class=" label" for="registration_parents_attributes_date_of_birth_2">Geboortedatum</label><input id="registration_parents_attributes_date_of_birth_2" name="registration[parents_attributes][date_of_birth_2]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_language_2_input"><label class=" label" for="registration_parents_attributes_language_2">Spreektaal</label><input id="registration_parents_attributes_language_2" maxlength="255" name="registration[parents_attributes][language_2]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_bsnr_2_input"><label class=" label" for="registration_parents_attributes_bsnr_2">Burgerservicenr</label><input id="registration_parents_attributes_bsnr_2" maxlength="9" name="registration[parents_attributes][bsnr_2]" size="9" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_education_level_2_input"><label class=" label" for="registration_parents_attributes_education_level_2">Hoogst genoten opleiding</label><input id="registration_parents_attributes_education_level_2" maxlength="60" name="registration[parents_attributes][education_level_2]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_profession_2_input"><label class=" label" for="registration_parents_attributes_profession_2">Beroep</label><input id="registration_parents_attributes_profession_2" maxlength="255" name="registration[parents_attributes][profession_2]" type="text" /> </li> <li> <p class='inline-hints'>Als u hier geen adres invult, wordt automatisch het adres van ouder/verzorger 1 overgenomen.</p> </li> <li class="string input optional stringish" id="registration_parents_attributes_street_2_input"><label class=" label" for="registration_parents_attributes_street_2">Straat</label><input id="registration_parents_attributes_street_2" maxlength="60" name="registration[parents_attributes][street_2]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_number_2_input"><label class=" label" for="registration_parents_attributes_number_2">Huisnummer</label><input id="registration_parents_attributes_number_2" maxlength="10" name="registration[parents_attributes][number_2]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_extension_2_input"><label class=" label" for="registration_parents_attributes_extension_2">Huisnummertoevoeging</label><input id="registration_parents_attributes_extension_2" maxlength="10" name="registration[parents_attributes][extension_2]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_postcode_nrs_2_input"><label class=" label" for="registration_parents_attributes_postcode_nrs_2">Postcode nr</label><input id="registration_parents_attributes_postcode_nrs_2" maxlength="5" name="registration[parents_attributes][postcode_nrs_2]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_postcode_chars_2_input"><label class=" label" for="registration_parents_attributes_postcode_chars_2">Postcode (ltrs)</label><input id="registration_parents_attributes_postcode_chars_2" maxlength="2" name="registration[parents_attributes][postcode_chars_2]" size="2" style="text-transform: uppercase;" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_city_2_input"><label class=" label" for="registration_parents_attributes_city_2">Woonplaats</label><input id="registration_parents_attributes_city_2" maxlength="60" name="registration[parents_attributes][city_2]" type="text" /> </li> <li class="select input optional" id="registration_parents_attributes_country_2_input"><label class=" label" for="registration_parents_attributes_country_2">Land</label><select id="registration_parents_attributes_country_2" name="registration[parents_attributes][country_2]"><option value="Nederland" selected="selected">Nederland</option> <option value="België">België</option> <option value="Duitsland">Duitsland</option> <option value="Land Onbekend">Land Onbekend</option></select> </li> <li class="string input optional stringish" id="registration_parents_attributes_phone_2_input"><label class=" label" for="registration_parents_attributes_phone_2">Telefoon (thuis)</label><input id="registration_parents_attributes_phone_2" maxlength="255" name="registration[parents_attributes][phone_2]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_mobile_2_input"><label class=" label" for="registration_parents_attributes_mobile_2">Telefoon (mobiel)</label><input id="registration_parents_attributes_mobile_2" maxlength="255" name="registration[parents_attributes][mobile_2]" type="text" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_work_phone_2_input"><label class=" label" for="registration_parents_attributes_work_phone_2">Telefoon (werk)</label><input id="registration_parents_attributes_work_phone_2" maxlength="255" name="registration[parents_attributes][work_phone_2]" type="text" /> </li> <li class="email input optional stringish" id="registration_parents_attributes_email_2_input"><label class=" label" for="registration_parents_attributes_email_2">Email</label><input id="registration_parents_attributes_email_2" maxlength="60" name="registration[parents_attributes][email_2]" size="20" type="email" /> </li> <li class="string input optional stringish" id="registration_parents_attributes_bic_code_2_input"><label class=" label" for="registration_parents_attributes_bic_code_2">BIC code</label><input id="registration_parents_attributes_bic_code_2" maxlength="255" name="registration[parents_attributes][bic_code_2]" type="text" /> </li> </ol></fieldset> </div> <div class='form_group' id='parent'> <h3 class='registration'>Noodpersoon</h3> <fieldset class="inputs"><ol><li class="string input optional stringish" id="registration_emergency_person_attributes_title_input"><label class=" label" for="registration_emergency_person_attributes_title">Aanhef</label><input id="registration_emergency_person_attributes_title" maxlength="255" name="registration[emergency_person_attributes][title]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_initials_input"><label class=" label" for="registration_emergency_person_attributes_initials">Initialen</label><input id="registration_emergency_person_attributes_initials" maxlength="10" name="registration[emergency_person_attributes][initials]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_firstname_input"><label class=" label" for="registration_emergency_person_attributes_firstname">Voornaam</label><input id="registration_emergency_person_attributes_firstname" maxlength="60" name="registration[emergency_person_attributes][firstname]" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_in_between_first_and_lastname_input"><label class=" label" for="registration_emergency_person_attributes_in_between_first_and_lastname">Tussenvoegsel</label><input id="registration_emergency_person_attributes_in_between_first_and_lastname" maxlength="10" name="registration[emergency_person_attributes][in_between_first_and_lastname]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_lastname_input"><label class=" label" for="registration_emergency_person_attributes_lastname">Achternaam<abbr title="required">*</abbr></label><input id="registration_emergency_person_attributes_lastname" maxlength="60" name="registration[emergency_person_attributes][lastname]" type="text" /> </li> <li class="select input optional" id="registration_emergency_person_attributes_function_input"><label class=" label" for="registration_emergency_person_attributes_function">Relatie</label><select id="registration_emergency_person_attributes_function" name="registration[emergency_person_attributes][function]"><option value=""></option> <option value="father">Vader</option> <option value="mother">Moeder</option> <option value="stepparent">Stiefouder</option> <option value="bonusparent">Bonusouder</option> <option value="caretakers">Verzorger</option> <option value="grandfather">Opa/oma</option> <option value="contactperson">Contactpersoon</option> <option value="other">Overig</option></select> </li> </ol></fieldset><fieldset class="inputs"><ol><li class="string input optional stringish" id="registration_emergency_person_attributes_street_input"><label class=" label" for="registration_emergency_person_attributes_street">Straat</label><input id="registration_emergency_person_attributes_street" maxlength="60" name="registration[emergency_person_attributes][street]" type="text" /> </li> <li class="string input required stringish" id="registration_emergency_person_attributes_number_input"><label class=" label" for="registration_emergency_person_attributes_number">Huisnummer<abbr title="required">*</abbr></label><input id="registration_emergency_person_attributes_number" maxlength="10" name="registration[emergency_person_attributes][number]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_extension_input"><label class=" label" for="registration_emergency_person_attributes_extension">Huisnummertoevoeging</label><input id="registration_emergency_person_attributes_extension" maxlength="10" name="registration[emergency_person_attributes][extension]" size="10" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_postcode_nrs_input"><label class=" label" for="registration_emergency_person_attributes_postcode_nrs">Postcode nr</label><input id="registration_emergency_person_attributes_postcode_nrs" maxlength="5" name="registration[emergency_person_attributes][postcode_nrs]" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_postcode_chars_input"><label class=" label" for="registration_emergency_person_attributes_postcode_chars">Postcode (ltrs)</label><input id="registration_emergency_person_attributes_postcode_chars" maxlength="2" name="registration[emergency_person_attributes][postcode_chars]" size="2" style="text-transform: uppercase;" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_city_input"><label class=" label" for="registration_emergency_person_attributes_city">Woonplaats</label><input id="registration_emergency_person_attributes_city" maxlength="60" name="registration[emergency_person_attributes][city]" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_phone_input"><label class=" label" for="registration_emergency_person_attributes_phone">Telefoon (thuis)</label><input id="registration_emergency_person_attributes_phone" maxlength="255" name="registration[emergency_person_attributes][phone]" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_mobile_input"><label class=" label" for="registration_emergency_person_attributes_mobile">Telefoon (mobiel)</label><input id="registration_emergency_person_attributes_mobile" maxlength="255" name="registration[emergency_person_attributes][mobile]" type="text" /> </li> <li class="string input optional stringish" id="registration_emergency_person_attributes_work_phone_input"><label class=" label" for="registration_emergency_person_attributes_work_phone">Telefoon (werk)</label><input id="registration_emergency_person_attributes_work_phone" maxlength="255" name="registration[emergency_person_attributes][work_phone]" type="text" /> </li> <li class="email input optional stringish" id="registration_emergency_person_attributes_email_input"><label class=" label" for="registration_emergency_person_attributes_email">Email</label><input id="registration_emergency_person_attributes_email" maxlength="60" name="registration[emergency_person_attributes][email]" size="20" type="email" /> </li> </ol></fieldset> </div> <div class='clear'></div> <div class='form_group' id='parent'> <fieldset class="actions" id="registration_buttons"><ol><input id="accept_privacy_statement" name="accept_privacy_statement" onclick="toggle_on_accept()" type="checkbox" value="1" /> Ik ga akkoord met het <a href="https://kdvnet3.s3.amazonaws.com/uploads/148ffb49-c16e-406e-8e3c-bf248543d47f/Bloem_PrivacyStatement.pdf">Privacy Statement</a> <li class="action input_action " id="registration_submit_action"><input id="form-submit-button" name="commit" type="submit" value="Aanmelding verzenden" /></li> </ol></fieldset></div> </form> </div> <script> $( "form#new_registration" ).submit(function() { var answers = []; $('.consent-required').each(function(){ var consentAnswer = $(this).val(); answers.push(consentAnswer); }); if (answers.includes('')){ alert('Selecteer Ja of Nee voor elke verplichte Toestemmingsvraag (met *).'); return false; } else { $('#form-submit-button').prop("disabled", true); } }); function showRegistrationBicCode(){ if ($('select#registration_parents_attributes_country_1').val() == "Nederland"){ $('li#registration_parents_attributes_bic_code_1_input').hide() } else { $('li#registration_parents_attributes_bic_code_1_input').show() }; if ($('select#registration_parents_attributes_country_2').val() == "Nederland"){ $('li#registration_parents_attributes_bic_code_2_input').hide() } else { $('li#registration_parents_attributes_bic_code_2_input').show() }; }; function toggle_jointly_income(value){ if (value == 'U woont samen en één partner is niet werkzaam' || value == 'U woont samen en beide partners zijn niet werkzaam' || value == 'U bent alleen en niet werkzaam'){ $('li#registration_parents_attributes_jointly_income_input').show(); } else { $('li#registration_parents_attributes_jointly_income_input').hide(); } }; function toggle_on_accept(){ if (document.getElementById('accept_privacy_statement').checked){ $(':input[type="submit"]').prop('disabled', false); } else { $(':input[type="submit"]').prop('disabled', true); } }; toggle_on_accept(); $( document ).ready( function(){ $('#registration_child_attributes_date_of_birth').datepicker({yearRange: '1930:2050', firstDay: 1}); $('#registration_parents_attributes_date_of_birth_1').datepicker({yearRange: '1930:2050', firstDay: 1}); $('#registration_parents_attributes_date_of_birth_2').datepicker({yearRange: '1930:2050', firstDay: 1}); $('#registration_emergency_person_attributes_date_of_birth').datepicker({yearRange: '1930:2050', firstDay: 1}); $('#registration_preferred_start_date').datepicker({yearRange: '1930:2050', firstDay: 1}); $('#registration_preferred_end_date').datepicker({yearRange: '1930:2050', firstDay: 1}); showRegistrationBicCode(); $('select#registration_parents_attributes_country_1').bind('change', function(){ showRegistrationBicCode() }); $('select#registration_parents_attributes_country_2').bind('change', function(){ showRegistrationBicCode() }); if( $('input#registration_child_attributes_disable_bsnr').prop('checked')){ $('input#registration_child_attributes_bsnr').attr('disabled', 'disabled'); $('input#registration_child_attributes_bsnr').val(''); $('select#registration_child_attributes_class_room_id').attr('disabled', 'disabled'); $('select#registration_child_attributes_class_room_id').val(''); $('textarea#registration_child_attributes_vaccination_notes').attr('disabled', 'disabled'); $('textarea#registration_child_attributes_vaccination_notes').val(''); }; $('input#registration_child_attributes_disable_bsnr').bind('change', function(){ if( $('input#registration_child_attributes_disable_bsnr').prop('checked')){ $('input#registration_child_attributes_bsnr').attr('disabled', 'disabled'); $('input#registration_child_attributes_bsnr').val(''); $('select#registration_child_attributes_class_room_id').attr('disabled', 'disabled'); $('select#registration_child_attributes_class_room_id').val(''); $('textarea#registration_child_attributes_vaccination_notes').attr('disabled', 'disabled'); $('textarea#registration_child_attributes_vaccination_notes').val(''); }else{ $('input#registration_child_attributes_bsnr').removeAttr('disabled'); $('textarea#registration_child_attributes_vaccination_notes').removeAttr('disabled'); $('select#registration_child_attributes_class_room_id').removeAttr('disabled'); }; }); // show or hide select input jointly income when rerendered form in case of a validation error toggle_jointly_income($('select#registration_parents_attributes_personal_situation')[0].value); $('select#registration_parents_attributes_personal_situation').bind('change', function(){ toggle_jointly_income(this.value); }); }); </script> </div> </body> </html>