[PDF] VERDIÉ OPEN CLASS FICHE SANITAIRE DE LIAISON



Previous PDF Next PDF
























[PDF] instruments jazz cycle 3

[PDF] economie 1re stmg nathan corrigé pdf

[PDF] livre economie 1re stmg hachette corrigé

[PDF] les suds a arles pass tous concerts 10 juillet

[PDF] element de construction de batiment pdf

[PDF] methode des elements finis en genie civil

[PDF] méthode des éléments finis exercices corrigés

[PDF] hcp maroc

[PDF] guide impots vaud 2016

[PDF] fiche de lecture le petit violon

[PDF] histoire du soldat stravinsky youtube

[PDF] l'histoire du soldat stravinsky partition

[PDF] les songes dans la bible

[PDF] clovis et les francs

[PDF] clovis et les mérovingiens cycle 3

VERDIÉ OPEN CLASS FICHE SANITAIRE DE LIAISON

VERDIÉ OPEN CLASS

FICHE SANITAIRE DE LIAISON

Votre enfant va prochainement partir en voyage scolaire. Vous trouverez ci-dessous toutes les informations à

communiƋuer au professeur organisateur afin Ƌu͛il puisse complĠter correctement la liste des participants au

voyage. Nous vous remercions de porter une attention particulière aux informations indiquées, celles-ci sont

importantes afin d͛assurer une organisation optimale du sĠjour. Les champs suiǀis d͛une Ύ sont obligatoires

IDENTITÉ DE L'ÉLÈVE

Nom* " " " " " " " " "" " " " " " " " " Prénom* " " " " " " " " " " " " " " Né(e) le* " " " " " " " " " " " Nationalité* " " " " " " " " " " " " "

Sexe* : ެ Garçon ެ

Mail " " " " " " " " " " " " " " " " " " " "

Téléphone : " " " " " " " " " " " " " " " " " " " " Type de document d'identité* " " " " " " " " " " " " " " " " " " " " " " " " " " " " " N° du document* " " " " " " " " " " " " " " " " " " " " " " "

Date d'expiration* " " " " " " " " " " "

Pays de délivrance* " " " " " " " " " " " " " " " " " " " " " "

RESPONSABLE LÉGAL DE L'ÉLÈVE

Nom* " " " " " " " " "" " " " " " " " " Prénom* " " " " " " " " " " " " " " Adresse 1 " " " " " " " " " " " " " " " " " " " " " " Adresse 2 " " " " " " " " " " " " " " " " " " " " " " Adresse 3 " " " " " " " " " " " " " " " " " " " " " " CP " " " " " " " " " " " Ville " " " " " " " " " " " " " " " " Coordonnées téléphoniques (joignable pendant le séjour)* " " " " " " " " " " " " " "

E-mail " " " " " " " " " " " " " " " " " " " " "

SANTE & ALIMENTATION

HANDICAP : ެ Non ެ

Précision sur les besoins G MVVLVPMQŃH : " " " " " " " " " " " " " " " " " " " " " " " " " "

SPECIFICITES ALIMENTAIRES (*0HUŃL GH SUpŃLVHU OH GHJUp GH O MOOHUJLH VpYqUH RX OpJqUH HP GH vous

rapprocher du professeur organisateur) :

SPECIFICITES DE SANTE (*Merci de précisHU OH GHJUp GH O MOOHUJLH (sévère ou légère) et de vous rapprocher

du professeur organisateur) : AUTRE PARTICULARITE :" " " " " " " " " " " " " " " " " " " " " " " " " " " " " " "quotesdbs_dbs2.pdfusesText_3