Welcome to ILRCC – Book Multiple Programs "*" indicates required fields Are you a member?*YesNoParticipants Name* First Last Main Contact Email* Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Emergency Contact Name* First Last Emergency Contact Email* Emergency Contact Phone*Will participant use Access Calgary to come to programs? Access # If participant is arriving by Access Calgary, do they need to be handed over? Primary Support Person Name First Last Primary Support Person PhoneMedical concerns/conditions ((including dietary and other restrictions such as caffeine, sugar, etc.)What to do to do if one of the concerns is encountered.Anything that would be helpful to staff while attending community and social events with you? (behavioural challenges, noise or light sensitivities, fears such as heights or loud bangs, stairs or escalators, etc., anxiety or other social phobias)?Do you use a walker, wheel chair or other assistive technology that we should know about?PaymentsMonday Arts & Drawing Registration Quantity Price: $ 135.00 CAD Quantity $135.00/program Monday Noon Cooking Registration Quantity Price: $ 75.00 CAD Quantity $75.00/program Tuesday Arts & Crafts Registration Quantity Price: $ 135.00 CAD Quantity $135.00/program Tuesday Desserts Quantity Price: $ 75.00 CAD Quantity $75.00/program Wednesday Gentle Yoga Quantity Price: $ 110.00 CAD Quantity $110.00/program Wednesday Noon Cooking Quantity Price: $ 75.00 CAD Quantity $75.00/program Wednesday Pizza Night Registration Quantity Price: $ 110.00 CAD Quantity $110.00/program Thursday Arts & Crafts Registration Quantity Price: $ 135.00 CAD Quantity $135.00/program Thursday Noon Cooking Quantity Price: $ 75.00 CAD Quantity $75.00/program Thursday Dance & Sing Registration Quantity Price: $ 75.00 CAD Quantity $75.00/program Friday Mix & Mingle Quantity Price: $ 20.00 CAD Quantity $20.00/program Saturday Bowling Registration Quantity Price: $ 110.00 CAD Quantity $110.00/program Miscellaneous Amount Total Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name CAPTCHA
