Fields marked with * are mandatory

Child

Name

First name

Date of birth

Sex*: GirlBoy

Nationality

Address

Mother

Name

First name

Nationality

Civil status

Address

Email

Profession

Landline telephone

Mobile phone

Business telephone

Father

Name

First name

Nationality

Civil status

Address

Profession

Landline telephone

Mobile phone

Business telephone

Desired reception at the crèche

Attendance rate (%)

Desired days of the week : Monday morningMonday afternoonTuesday morningTuesday afternoonWednesday morningWednesday afternoonThursday morningThursday afternoonFriday morningFriday afternoon

Desired date of entry to the nursery

In order to keep your registration on the waiting list, it is necessary to confirm it every three months by phone or email.