59 years of quality
and experience
for you and your child

Request for a childcare place

Registration form

Day Care Center

*

Mother/Partner

First name/Surname

Street/Street number/zip code/city

Private phone number

Mobile phone number

Business phone number

E-Mail *

Employer

Father/Partner

First name/Surname

Street/Street number/Zip code/City

Private phone number

Mobile phone number

Business phone number

E-Mail

Employer

1. Child

First name/Surname

Date of birth

Desired entry from

School/Kindergarten

2. Child

First name/Surname

Date of birth

Desired entry from

School/Kindergarten

Desired care times

Monday

Tuesday

Wednesday

Thursday

Friday

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