EASL – Double Caring

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Child Intake Form

Dear parent/carer, we are happy to welcome your child(ren) at the EASL childcare - taking place from 27-30 May 2026 - and organized by Double Daycare. Please register your child(ren) here. Closer towards the event, you’ll receive further information about the daycare program. Should you need any further information, please do not hesitate to contact us: events@doubledaycare.nl Thank you in advance!

Contact: events@doubledaycare.nl

First and surname parent/carerRequired

First name Surname

Number of childrenRequired

Please enter a number from 1 to 4.

Phone number + Country code parent/carerRequired

Email address parent/carerRequired

Child information

Child’s name + surnameRequired

First name Surname

Date of birthRequired

DD slash MM slash YYYY

GenderRequired

Male

Female

Native languageRequired

Does your child speaks / understands EnglishRequired

Yes, fluently (speaking and understanding)

He/she can speak English a bit, but understands well enough

He/she can't speak English at all, but might understand a little bit

No, not at all

Does your child has any allergiesRequired

Yes

What type of allergie(s) has your child

Is your child potty trainedRequired

Yes

Does your child need to take a nap during daycare time? If so, tell us any specifics (time, duration, pacifier etc.)Required

Please tell us some relevant information about your child. What does he/she loves to do?Required

Child information

Child’s name + surnameRequired

First name Surname

Date of birthRequired

DD slash MM slash YYYY

GenderRequired

Male

Female

Native languageRequired

Does your child speaks / understands EnglishRequired

Yes, fluently (speaking and understanding)

He/she can speak English a bit, but understands well enough

He/she can't speak English at all, but might understand a little bit

No, not at all

Does your child has any allergiesRequired

Yes

What type of allergie(s) has your child

Is your child potty trainedRequired

Yes

Does your child need to take a nap during daycare time? If so, tell us any specifics (time, duration, pacifier etc.)Required

Please tell us some relevant information about your child. What does he/she loves to do?Required

Child information

Child’s name + surnameRequired

First name Surname

Date of birthRequired

DD slash MM slash YYYY

GenderRequired

Male

Female

Native languageRequired

Does your child speaks / understands EnglishRequired

Yes, fluently (speaking and understanding)

He/she can speak English a bit, but understands well enough

He/she can't speak English at all, but might understand a little bit

No, not at all

Does your child has any allergiesRequired

Yes

What type of allergie(s) has your child

Is your child potty trainedRequired

Yes

Does your child need to take a nap during daycare time? If so, tell us any specifics (time, duration, pacifier etc.)Required

Please tell us some relevant information about your child. What does he/she loves to do?Required

Child information

Child’s name + surnameRequired

First name Surname

Date of birthRequired

DD slash MM slash YYYY

GenderRequired

Male

Female

Native languageRequired

Does your child speaks / understands EnglishRequired

Yes, fluently (speaking and understanding)

He/she can speak English a bit, but understands well enough

He/she can't speak English at all, but might understand a little bit

No, not at all

Does your child has any allergiesRequired

Yes

What type of allergie(s) has your child

Is your child potty trainedRequired

Yes

Does your child need to take a nap during daycare time? If so, tell us any specifics (time, duration, pacifier etc.)Required

Please tell us some relevant information about your child. What does he/she loves to do?Required

Select day(s)Required

Wednesday May 27: 7:30-13:00

Wednesday May 27: 13:00-19:00

Thursday May 28: 7:30-13:00

Thursday May 28: 13:00-18:00

Friday May 29: 7:30-13:00

Friday May 29: 13:00-18:00

Saturday May 30: 7:30-12:00

Saturday May 30: 12:00-16:00

Total amount

Bereken prijs

Price: 0,00 €

Payment method*

American Express

Discover

MasterCard

Visa

Maestro

Supported Credit Cards: American Express, Discover, MasterCard, Visa, Maestro

Card Number Expiration Date Security Code Cardholder Name

EASL 2026

Child Intake Form

Contact: events@doubledaycare.nl

Child information

Child information

Child information

Child information

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