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Last Name*

Your first Name*

Confirm Email Address*

Your Email Address*

Phone number 2 (in case of emergency)*

Phone Number*

Child's Date of Birth (dd/mm/yyyy)*

Your Child's FULL Name*

Which class do you want your child to participate to? Which class do you want your child to participate to? ACTING CLASSES SINGING CLASSES MUSICAL THEATRE THEATRE JAZZ CLASSES TAP DANCING CLASSES

What age group is Child 1? What age group is Child 1? Pre-Junior (4 to 7 yr) Junior (8 to 11 yr) Teens (12 to 15 yr)

Child's Gender Child's Gender Boy Girl

Do you want to register a second child? Do you want to register a second child? Yes, please No, thank you

Child 2 FULL Name*

Child 2 Date of Birth (dd/mm/yyyy)*

Child 2 Gender Child 2 Gender Boy Girl

Which class do you want child 2 to participate to? Which class do you want child 2 to participate to? ACTING CLASSES SINGING CLASSES MUSICAL THEATRE THEATRE JAZZ CLASSES TAP DANCING CLASSES

What age group is Child 2? What age group is Child 2? Pre-Junior (4 to 7 yr) Junior (8 to 11 yr) Teens (12 to 15 yr)

Does any of the children registered above have any particular condition (medical or physical) that we should be aware of?

Free Trial & Newsletter Free Trial & Newsletter I would like to receive LVBA newsletter and events updates

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