Dětská skupina Borůvka

T.G. Masaryka 721, Choceň 565 01, Dětská skupina Litomyšl, z.s., se sídlem Květná 1871/15, Boskovice 680 01, IČO: 06325645, q9fp2uz, 603 846 662, [email protected], https://safariclub.cz/ds-chocen-boruvka/

Žádost o umístění dítěte do dětské skupiny

Žádám o umístění svého dítěte do Dětské skupiny Borůvka („Dále jen DS“), potvrzuji správnost uvedených údajů a seznámení se s Plánem výchovy a péče a Vnitřními pravidly.

Child's personal details

Name

Surname

Date of birth

Does your child have siblings in our preschool?

Preliminary expected start date

Citizenship

Does your child have special educational requirements?

Additional information

I acknowledge that the child must be properly vaccinated at the time of entry to DS (except for children attending compulsory preschool and children with a permanent contraindication).

Child's address Please enter the permanent address for your child.

Street

Conscription number

Street number

Country

Region

City

City district

ZIP code

Permanent address of the child corresponds to the child's actual residing address

Correspondence address Please enter the mailing address for your child

Street

Conscription number

Street number

Country

Region

City

City district

ZIP code

Legal guardian

Legal representative for negotiations with the organization

Add guardian

I hearby declare that all information entered in the application are true, accurate, and complete

Date

Place

Submit application