5364 State Hwy. 51 • West Burlington, NY 13482 • 607-376-7876
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Online Fall Registration Form

Please complete the Online Registration Form below.

After completing and submitting this form, we will have one of our qualified staff teachers contact you to help schedule classes for you or your children.

Parent/Guardian:*
Address:*
City, State, Zip:*
Phone:*     Cell Phone:  
Email:*
Emergency Contact:*
Phone:*     Cell Phone:  
How did you hear of us? Post Card     Newspaper     Word of Mouth
  Other: 

Complete the following information for each student.

Student 1:
Age:     Birth Date:  
Enrolling in: Pre-Dance (ages 3-4)    Primary Combo (ages 5-6)
Ballet    Pointe    Ballet Technique    Tap
Jazz    Lyrical    Musical Theatre    Acrobatics
K-Pop    Modern    Acting    Vocal Coaching
Solo or Duo/Trio:

 

 Note: Solo or Duo/Trio classes are not guaranteed
 a spot in the recital
 
Student 2:
Age:     Birth Date:  
Enrolling in: Pre-Dance (ages 3-4)    Primary Combo (ages 5-6)
Ballet    Pointe    Ballet Technique    Tap
Jazz    Lyrical    Musical Theatre    Acrobatics
K-Pop    Modern    Acting    Vocal Coaching
Solo or Duo/Trio:

 

 Note: Solo or Duo/Trio classes are not guaranteed
 a spot in the recital
 
Student 3:
Age:     Birth Date:  
Enrolling in: Pre-Dance (ages 3-4)    Primary Combo (ages 5-6)
Ballet    Pointe    Ballet Technique    Tap
Jazz    Lyrical    Musical Theatre    Acrobatics
K-Pop    Modern    Acting    Vocal Coaching
Solo or Duo/Trio:

 

 Note: Solo or Duo/Trio classes are not guaranteed
 a spot in the recital

If you have any questions or information, or you or your children have any special needs we should know about, please list them in the comments box below.

Comments:
 
I assume all financial responsibilities for the above student(s) at
Otsego School of Dance and Performing Arts I agree*
School Policies: View and Read I agree*
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