Formulaire d'inscription � ACKG

01Student

First name

Last name

Date of birth

Gender Girl Boy

School attended

Class

Teacher

Language spoken at home

02Legal guardian

Parent / Tuteur 1

Last name

First name

Phone

Parent / Tuteur 2

Last name

First name

Phone

03Address

Street

Postal code / City

04Additional information

Allergies

Remarks

05Image rights

I authorize ACKG to use photos or videos of my child:

Website Social media Association publications Activity reports

I authorize I refuse

This authorization is valid for the current school year.

06Signature

Place and date

Signature of legal guardian

Return this form to the association or send it by e-mail to info@ackg.ch