Application form

Child information

 
Family name *
 
First name *
 
Date of birth *
 
Nationality (s) *
 
Girl
Boy
 
Home address *
 
 

Parents information

 
Father's name *
 
Occupation *
 
Employer name *
 
E.mail *
 
Phone *
 
 
 
Mother's name *
 
Occupation *
 
Employer name *
 
E.mail *
 
Phone *
 
 
 

Emergency contacts

 
Full Name one *
 
Relationship to the child one *
 
Phone one *
 
Full Name two *
 
Relationship to the child two *
 
Phone two *
 
Full name three *
 
Relationship to the child three *
 
Phone three *
 
 

Persons allowed to pick up the child

 
Full name one *
 
Relationship to the child one *
 
Phone one *
 
Full name two *
 
Relationship to the child two *
 
Phone two *
 
Full name three *
 
Relationship to the child three *
 
Phone three *
 
 
Date *
Security Code *
 
 
 
 
 
 

Our Events

 
 

Our Programs

 
 
 

Our Hours

MONDAY TO FRIDAY
7:30 am to 3:00pm

Extendable to 5:00 pm

 

Our Newsletter

Our Location

 

Contact Us

 
© 2024 Chez Moi | All Rights Reserved | Powered & Designed by Asmar Pro