Concept
Participant's Identity
Name:
*
Date of birth:
Place of birth:
Nationality:
Sex:
Boy
Girl
Registration
Session:
1
2
3
4
From:
To:
Number of sessions:
Further Information
Name of Father:
*
Professional:
Name of Mother:
*
Complete Address:
*
Tel. 1:
*
Tel. 2:
Fax:
Cell:
E-mail:
Name & address of the legal guardian:
Tel. 1:
Fax:
Cell:
Health Form
Treatments to be observed meticulously:
Blood group:
Allergies:
Special Remarks:
Name of pediatrician:
Tel.:
Cell:
By their signature, parents certify that their child is in perfect health.
By his signature, the parent or guardian accepts the general conditions of this contract.
Name:
City:
Date:
Signature:
(*): Required
Instructors
Accommodation
Food & beverage
Activities
Insurance
Admission Form
General
Conditions
