Waiting List

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2023-2024 New Bremen Dance Waiting List Form

Students Name: ______________________________________________________

Parents Name: ______________________________________________________

Address: ________________________________ City:______________________ Zip: ______

Email Address: ___________________________________ Phone Number: _____________________

Birth date: _______________ Age (as of 7-31-2023): _________ Grade entering (as of fall 2023): ________


What class would student like to enroll in?

____ Combination Dance class (age 6 and up)____ Introduction to dance class (age 3 1/2 to 5)
____ Girls tumbling class (age 4 and up)____ Ballet class (age 10 and up – prerequisite for Pointe class)
____ Pointe class


• Where did you hear about New Bremen Dance School?


• What previous experience has the student had in dance or gymnastics? (where, how long, etc.)


• The student cannot take lessons on the following days or times:



Parents Signature ______________________________________________________

Please mail this form in right away. The sooner you mail it, the better chance your child has of securing a spot in a dance or tumbling class.

Return to: Lynda R. Davis  |  232 S Washington Street  |  New Bremen, Ohio 45869-1251  |  419-234-0630