Rix Kix Arts Online Registration

Registration

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Welcome to Rix Kix Arts! Please complete the following registration form to enrol in classes.

* denotes required fields

Referral Information

How did you hear about us?*

Family Information

Family Last Name*

Where do you live?

Home Address*

Home or Primary Phone*

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

How can we contact you?

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email*

T-Shirt Size

N.T Gov. Sports Voucher Sem. 1

N.T Gov. Sports Voucher Sem. 2

Please click on the Search button below, then choose the class. If using a Sports Voucher, please list the full number in the corresponding semester box.

Enroll in Classes

Select Another Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email*

T-Shirt Size

N.T Gov. Sports Voucher Sem. 1

N.T Gov. Sports Voucher Sem. 2

Please click on the Search button below, then choose the class. If using a Sports Voucher, please list the full number in the corresponding semester box.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email*

T-Shirt Size

N.T Gov. Sports Voucher Sem. 1

N.T Gov. Sports Voucher Sem. 2

Please click on the Search button below, then choose the class. If using a Sports Voucher, please list the full number in the corresponding semester box.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email*

T-Shirt Size

N.T Gov. Sports Voucher Sem. 1

N.T Gov. Sports Voucher Sem. 2

Please click on the Search button below, then choose the class. If using a Sports Voucher, please list the full number in the corresponding semester box.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email*

T-Shirt Size

N.T Gov. Sports Voucher Sem. 1

N.T Gov. Sports Voucher Sem. 2

Please click on the Search button below, then choose the class. If using a Sports Voucher, please list the full number in the corresponding semester box.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

(Show-Hide Details)

Policy

I've read the above and agree.

Permission

I've read the above and agree.

Conduct

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Please fill out CREDIT CARD Payment Method

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Post Code*

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank State Branch (BSB) Number (6-digit number)

Account Number

Registration

Referral Information

Family Information

Where do you live?

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies and Agreements (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

eCheck/Bank Draft

Required Policies and Agreements

(Show-Hide Details)