dossier d'inscription stage de comedie musicale - Courchevel
dossier d'inscription stage de comedie musicale - Courchevel
dossier d'inscription stage de comedie musicale - Courchevel
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DOSSIER D’INSCRPTION<br />
Comédie <strong>musicale</strong><br />
Page 1/4<br />
LE STAGAIRE<br />
NOM…………………………………………………………….<br />
PHOTO<br />
PRENOM……………………………………………………….<br />
SEXE Garçon Fille<br />
NE(E)<br />
LE……………………………….AGE…………………….ans<br />
ADRESSE………………………………………………………………………………………<br />
…………………………………………………………………………………………………..<br />
CODE POSTAL………………….. VILLE…………………………………….........<br />
LE REPRESENTANT LEGAL<br />
Père Mère Tuteur légal<br />
NOM………………………………….PRENOM……………………………………………..<br />
ADRESSE………………………………………………………………………………………<br />
…………………………………………………………………………………………………..<br />
CODE POSTAL………………….. VILLE…………………………………….........<br />
TEL DOMICILE…………………. TEL PRO……………………………………....<br />
TEL PORTABLE………………… EMAIL…………………………………………<br />
Autres personne à contacter en cas d’urgence :<br />
NOM………………………………….PRENOM……………………………………………..<br />
TEL DOM…………………TEL PRO………………….TEL PORT……………………
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