Application Form

Applicants Name

Applicants Email Address

Applicants Telephone Number

Applicants Date of Birth

How did you hear about DDMIX?

Qualifications

(you have acquired from employment or training)

Name of Fitness or Dance Qualification(s)

Year(s) Certified

Dancing Experience

(if applicable)

Schools

DDMIX is working closely with schools to introduce DDMIX into their timetables and develop after school clubs. If you are interested in teaching in schools please inform us. Please be advised to work in schools you will have to have a CRB check performed on you.

If you are interested in working in schools please tick this box.

It is the policy of DDMIX to provide equal opportunities without regard to race, colour, religion, national origin, gender, sexual preference, age, or disability.

Physical Activity Readiness Questionnaire

Before taking part in the DDMIX training course we want to know that you are ready and able to perform physical activity. There are aspects of this course which require physical activity and that you consent that you are able to perform these activities.

Please read the carefully and check YES or NO opposite the question if it applies to you. If yes, please explain.

1. Has your doctor ever said you have heart trouble?

Yes No

Please State

2. Do you frequently have pains in your heart and chest?

Yes No

Please State

3. Do you often feel faint or have spells of severe dizziness?

Yes No

Please State

4. Has a doctor ever said your blood pressure was too high?

Yes No

Please State

5. Has your doctor ever told you that you have a bone or joint problem(s), such as arthritis that has been aggravated by exercise, or might be made worse with exercise?

Yes No

Please State

6. Is there a good physical reason, not mentioned here, why you should not follow an activity program even if you wanted to?

Yes No

Please State

7. Are you or have you been pregnant in the last 6 months?

Yes No

8. Do you suffer from any problems of the lower back, i.e., chronic pain, or numbness?

Yes No

Please State

9. Are you currently taking any medications?

Yes No

Please Specify

10. Do you currently have a disability or a communicable disease?

Yes No

Please State

If you answered NO to all questions above, it gives a general indication that you may participate in this workshop. The fact that you answered NO to the above questions, is no guarantee that you will have a normal response to exercise. If you answered Yes to any of the above questions, then you may need written permission from a physician before participating in the physical aspects of this workshop.

DDMIX Training Course Feedback Form

Question: For each statement below, circle the number that you think reflects them the best rating them from 1 - 5 stars. 1 represents being poor, 5 being excellent.

Please rate your overall level of satisfaction with our training course

Please rate your overall level of satisfaction with the location

Please rate your overall level of satisfaction with the level of the teaching material

Please rate your overall level of satisfaction with the Music supplied

Please rate your overall level of satisfaction with the Master Instructor

What was the most beneficial part of this training course?

How do you think this training course could be improved?

Do you have any other comments or feedback you would like to give us.

The DDMIX training team are continuously striving to deliver the best training courses in the industry and welcome your feedback and joining us today for the training. Never hesitate to contact us in the future with any questions or queries.

FIND A CLASS NEAR YOU

WANT TO KEEP TO THE BEAT WITH OUR LATEST NEWS?