Rix Kix Dance Registration

Darwin Dance Lessons with Rix Kix provide a variety of experiences including zumba, childrens lessons, performing arts, choreographic work and stress reduction.

Rix Kix Registration
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-mail Address*
Street Address*
City*
State/Prov*
Zip/Postal Code*
Country*
Home Phone*
Business Phone*
Account Name*
D.O.B.*
Mobile Phone
Occupation*
Name of Dance Student’s School:*
Emergency Contact Name:*
Emergency Contact Phone:*
How did you hear about RIX KIX ARTS?*
Does the student have any injuries or restrictions?
Yes
No
If yes, please explain*
Has the student had any previous dance training?
If yes, please list previous dance history:

Please enter the word that you see below.

  



I, the adult applicant or I, the parent or legal guardian of the applicant listed above, hereby give approval of the applicant’s participation in any and all of RIX KIX ARTS Programs and activities registered. I do waive, release, absolve, indemnify and agree to hold harmless the organisers, sponsors, supervisors, participants and persons involved in the operation of RIX KIX ARTS or CDU Sports Complex, for any claims arising out of injury or other loss to named applicant or any member of his/her family whether as a participant in the activities or as a spectator. I also give permission for RIX KIX ARTS to take photos or video footage of the student to use for the website and other promotional purposes. I understand that any filming, online uploading or duplicating choreography without the permission of Kristy Rickert is strictly forbidden. If any student exhibits behavior that is dangerous to herself/himself or to other students, RIX KIX ARTS reserves the right to remove the student from the studio. I have read, understood and agree to the above statement. Adult Applicant or Parent/Guardian Signature _______________________________ Date __________



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girls at dance lessons
Rix Kix Dance Group

Rix Kix at Nightcliffe Seabreeze Festival
Rix Kix at Nightcliffe Seabreeze Festival