Ficha inscriçao ctl 2012
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Transcript of Ficha inscriçao ctl 2012
Nome: _______________________________________________________________________________________ nº de contribuinte ___________________________
Data de nascimento:_______/_______/___________ ano escolar:____________ turma:___________ nº cartão utente:______________________
Morada:________________________________________________________________________________________________________________________________________
____________________________________________________________________Localidade:________________________________________________________________
PESSOA RESPONSÁVEL (encarregado de educação)
Nome: ________________________________________________________________________ _____________ ___________________
Grau de parentesco:________________________________ contactos:________________________/________________________/________________________
Profissão:____________________________ mail:________________________________________________________________________________________________
Morada:________________________________________________________________________________________________________________________________________
____________________________________________________________________Localidade:________________________________________________________________
OUTROS CONTACTOS
Nome:________________________________________________________Parentesco:__________________telefone:____________________________________
Nome:________________________________________________________Parentesco:__________________telefone:____________________________________
AUTORIZAÇÃO DE SAÍDA
Nome:_______________________________________________________________Nome:___________________________________________________________________
Nome:_______________________________________________________________Nome:__________________________________________________________________
CUIDADOS ESPECIAIS
Doenças:____________________________________________________________Alergias:_______________________________________________________________
Restrições Alimentares:____________________________________________________________________________________________________________________
Outras informações consideradas de interesse:_____________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
T.P.C. Faz sempre Só à sexta Sempre que queira
Queijas, ____________ de____________________________________de ________________
O Responsável ____________________________________________________________________________________
Observações:_________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________________________
____________________ Sócio nº
CENTRO TEMPOS LIVRESFicha de inscrição
Somos pelas crianças.Rua de S. Romão, 1, 2790-435 Queijas - Tel APEE [email protected] - Cont. nº 506.381.293