Online registraTION FORM

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 - Child*
Surname - Child*
Personal identification number or Passport Number - Child*
Gender - Child*
Permanent Address in Prague - Family*
Date of Birth - Child*
Place of Birth - Child*
Residence Status - Child*
Nationality - Child*
What languages does your child speak?*
Attendance begins
Nursery - Programmes
Nursery - Days per Week
Preschool - Programmes
Preschool - Days per Week
Do you request Catering Services?*
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?*