Online Registration Form - Summer Camp

Name - Mother *
Surname - Mother*
Local Phone - Mother*
Date of Birth - Mother*
E-mail Address - Mother*
Name - Father *
Surname - Father*
Local Phone - Father*
Date of Birth - Father*
E-mail Address - Father*
Name of Child*
Surname of Child *
Personal identification number or Passport Number - Child*
Gender - Child*
Permanent Address in Prague - Family*
Date of Birth - Child*
Residence Status - Child*
Nationality - Child*
What languages does your child speak?*
Attendance begins
Does your the child sleep after lunch?*
Daily Routine
Dietary Restrictions
Doctor´s Name, Phone and Address*
Prescriptions Medications
Child´s Blood Type*
Medical Insurance Co.*
Illness or Conditions
Vaccination (immunization)*
Tell us more about your child
How did you hear about us?*