Registration Form for children

If you want to sign up your child in our database and recieve information on ongoing studies in which your child could participate, simply provide the information below. Please, note that your registration is without commitment.

As soon as we get your inscription, we will contact you to gather additional information. This will enable us to suggest you studies in which your child can participate. Of course, you can unsubscribe at any given moment of our database. Should you have any questions or concerns on the data base or studies, please do not hesitate to contact us.

*=information obligatoire

Parent's name *
Child's first name *
Child's gender		Female Male
Child's date of birth *
Address		Caractères restants:
email *
GSM
Do you prefer to be contacted by phone or by mail? * By mail By phone
Comments / Questions Caractères restants: