Registration Form Parents

Fields marked with an asterix(*) are mandatory.

Registration
 Amsterdam Utrecht Haarlem

General Information

Parents

Parent 1

 male female

Parent 2 (optional)

 male female
- a parent less + another parent

Children

Child 1

 boy girl

Child 2

 boy girl

Child 3

 boy girl

Child 4

 boy girl

Child 5

 boy girl
+ another child - a child less

Family

Payment Information

 I agree with the direct debit payment of €5,50 per month.

Final Information

 yes no
I agree with the terms of agreement
Babysitter request

Preferences OppasStudent

 male female no preference
 yes no preference
 yes no preference
 +/- two or three times a month  every week several times a week
 yes (condition if you need a babysitter three or more times a week) no n.a.

When a babysitter is needed at fixed times, fill in the schedule.
Please only fill in the days you need a babysitter (leave the other fields empty):

times
monday
thursday
wednesday
thursday
friday
saturday
sunday

When is a replacement needed?

from: till:

from: till:

from: till:
+ another date - a date less
Confirmation

General Information







Payment information:




Your babysitter request:

requested

The mediation costs for this request are €???.

LET OP: je aanvraag is pas definitief wanneer je betaling van de bemiddelingskosten via iDeal voldaan is.

Warning: Because your browser doesn't support javascript the connection with iDeal cannot be made automatically. Please contact OppasStudent for instructions on completing your registration.


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