Inscription Afterschool Care | Childcare & Day care Bambini Kids

Full name of child:

Given name of child:

Date of birth:

Gender:

Boy

Girl

Preferred date of placement:

At which school is your child enrolled ?

What grade your child is classified?

What is the name of the teacher?

Days of preference:

Location of preference:

Overdam

A.J. Ernststraat

At what is your child from school on Wednesday?

At what is your child from school on Friday?

Name of father:

Name of mother:

Street + home number:

Zip code:

Place of residence:

Phone: ^*

E-mail: ^*

Name on the invoices:

Father

Mother

Special wishes /remarks:

I acknowledge the Privacy Statement

^{Velden met een * zijn verplicht}

Laat dit veld leeg: ^*

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