Kinderwiese e.V. | 55118 Mainz |

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Child's data

First name*

Last Name*

Gender*

Date of birth*

Format: DD.MM.YYYY

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Desired enrolment date*

Format: DD.MM.YYYY

Start date flexible

Siblings

Others*

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Your details/details of primary contact

Gender*

First Name*

Surname*

Email address*

Phone*

Street and house number*

Zipcode *

Location:*

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Details of secondary contact person

Gender*

First name*

Surname*

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Phone*

Street and house number*

Zipcode *

Location*

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