Registration form for holiday childcare
Information about child
Name
*
first name
last name
Date of birth
*
.
Day
.
Month
Year
Gender
Please Select
male
female
Address
*
street
house number
postcode
town/city
canton
Daycare location
*
Please Select
Aarau
Herrliberg
Horw
Küssnacht am Rigi
Kriens
Littau
Neuhausen
Root
Rotkreuz
Sursee
Winterthur
Wülflingen
Zofingen
Please list all desired dates for holiday care. Please note that only full days can be booked:
*
Photo of the child
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Information about parents/guardians
also serves as the first emergency contact
Name
*
first name
last name
Relationship with the child
*
Phone number
*
Email address for invoicing
*
example@example.com
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Name
first name
last name
Relationship with the child
Phone number
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Additional information
Does the child suffer from allergies or intolerances? If so, please explain:
Does the child have any previous injuries? If so, please describe them:
Does the child suffer from any medical conditions? If so, please explain:
Is the child taking any medication? If so, please list the medication and explain its purpose:
Consent
I, the parent/legal guardian of the above-named child, authorise the staff of the daycare centre to provide medical assistance at their discretion in the event of an accident, injury or illness if the emergency contact person cannot be reached..
I confirm that all information provided in this form is true and complete.
Booked days can be cancelled free of charge up to two weeks before the planned holiday care. After that, the full amount is due before the start of care, as the place can no longer be filled by another child. This also applies in the event of the child falling ill.
The childcare days are only considered booked once they have been confirmed by faktura@kianakrippen.ch.
The price is based on the price list for the respective location, which is published on the website. (Zusatztag Schultarif)
By signing this document, parents/guardians confirm that they have read and accepted the kiana Education and Care Regulations (Terms and Conditions) and the above points.
Signature
*
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