Child Dance Class Registration Register now for the Lord Roberts Community Center Dance Class. If you have any questions you can contact us at programs@lordrobertscc.ca Class SelectionSelect a Class* Tuesday - Ballet/Jazz 1 ages 6-8 (4:30pm-5:30pm) Tuesday - Musical theatre 1 ages 6-8 (5:30pm-6:30) Tuesday - Ballet/Jazz 2 ages 9-12 (6:30pm-7:30pm) Tuesday - Musical theatre 2 ages 9-12 (7:30pm-8:30pm) Wednesday - Creative Movement ages 3-5 (5:00pm-5:45pm) Sunday - Parents and tots ages 2-3 (10:15am-11:00am) Parent or GuardianParent Name First Last Address* Street Address City Postal Code Phone*Email* Newsletter Signup Sign me up for the LRCC newsletter to hear about upcoming events. Relationship to children* Emergency ContactName* Phone Children ParticipatingName* First Last Birthdate*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920AgeMedical Conditions Epi Pen* Yes No Total $ 0.00 CAD How would you like to pay?* Pay online now Pay by cheque or cash at the LRCC Credit Card* Cardholder Name Card Details