CIRCO DE LOS NIÑOS
Formato de registro / Registration form
Email address *
Alumno dato / Student info
Apellido / Surname *
Your answer
Nombre / Name *
Your answer
Fecha de nacimiento / Birthday *
MM
/
DD
/
YYYY
Genero / Gender *
Nacionalidad / Nationality *
Your answer
Escuela / School *
Your answer
Donde vive / Where do you live *
Your answer
Desde cuando / Since when *
MM
/
DD
/
YYYY
Problemas medicos / Medical issues
Your answer
Informacion de la madre / Mother's info
Apellido / Surname
Your answer
Nombre / Name
Your answer
Correo electronico / E-Mail
Your answer
Facebook
Your answer
Telefono de casa / House phone
Your answer
Celular / Cellular
Your answer
Prefiero / I prefer
Informacion del padre / Father's info
Apellido / Surname
Your answer
Nombre / Name
Your answer
Correo electronico / E-Mail
Your answer
Facebook
Your answer
Teléfono de casa / House phone
Your answer
Celular / Cellular
Your answer
Prefiero / I prefer
Informacion de emergencia / Emergency info
Contacto / Contact 1 *
Your answer
Teléfono / Phone 1 *
Your answer
Teléfono / Phone 2
Your answer
Contacto / Contact 2
Your answer
Teléfono / Phone 1
Your answer
Teléfono / Phone 2
Your answer
Pago / Payment
Tipo de matricula / Tuition fees type *
Descuento o Patrocinador / Discount or Sponsor
Quiero inscribirme a / I want to register to *
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