Skate Like a Girl Program Partner Application

Thank you for your interest in partnering with Skate Like a Girl! For the last five years we have partnered with nearly 100 different schools, community centers, and organizations to bring school-based skateboarding enrichment to youth in all of our chapters. For more information on our programs and offerings, click here.

This form is for Schools (K-12), agencies (Boys and Girls Club, YMCA, etc), Parks and Rec Departments, and other entities who are interested in Skate Like a Girl providing ongoing programs at your site.

If you are interested in Skate Like a Girl coming to your event or other one-day opportunity, please fill out our Event Partner Application.

Which Skate Like a Girl Chapter are You Looking to Partner With? *

Name of School or Agency *

Have We Offered This Program to Your Site in the Past? *

YES NO Yes, but it was different/long time ago Unsure

Program Site Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Contact Name *

First Name Last Name

E-mail *

Phone Number *

- Area Code Phone Number

NEEDS FOR YOUR PROGRAM SITE:

Dates & Times of Program (Please be as Specific as Possible)

Gear Needed for Your Site (What You Need Skate Like a Girl to Provide)

Helmets Pads Skateboards

Do You Need Some Type of Curriculum for This Class (Beyond Skate Instruction)? *

Yes No, we just want participants to learn to skate! Unsure

If Yes, Please Describe Your Curriculum Needs:

Do you need us to do registration for this program? *

Yes, we do not have the ability to host registration No, we will do registration & give S.L.A.G. a roster of participants Unsure

Do you require additional insurance from Skate Like a Girl?

Yes No Not Sure

Are you able to get a Skate Like a Girl waiver signed by each participant's parent/guardian prior to start date of services?

Yes No

Any "Walk In" Participants? *

All participants will be "walk in" All participants will be pre-registered (on a roster) We will have both "walk in" and pre-registered participants

Amount of Participants: *

Under 7 7-14 15-21 22 or more Unsure

Ages of Participants (Check All That Apply) *

Pre School K-5th grade 6-9th grade 10-12th grade 18 years or older

Describe Your Group and/or Any Special Needs You Have:

WHAT YOUR PROGRAM SITE CAN PROVIDE:

Secure Gear Storage

Yes, we can provide a secure place to store gear No, we cannot provide storage unsure

Space to Provide Programming (Please Check All That Apply)

Indoor Area w/ smooth ground (example: Gym) Outdoor Covered Area w/ smooth ground (example: Covered play court) Outdoor Area w/ smooth ground (basketball court) Reserved Classroom (for "rainy day" art projects, videos, etc) Nearby Skate Park (15 minute walk or less) Our agency can provide transportation (example: Van to skate parks) We would like to meet at All Together Skate Park (indoor) in Fremont (additional fees apply)

Has the Skate Program Space Been Secured and Approved? *

Yes, we are approved to use the spaces/resources listed above No, we have not gotten approval yet

Can Your Site Provide Snacks?

Yes, we can No, we cannot Students provide their own snacks Unsure

Administrative Support (Check All That Apply)

Additional Staff and/or volunteer to support behavior management during class time Make roster & give to Skate Like a Girl prior to start of classes Collect Skate Like a Girl waivers prior to start of classes Support collection of demographic and other data for grant purposes

Fees for Skate Like a Girl Services:

Program Rate

$10/program hour/child. Rates cover staff, gear, and transportation. Subsidized rates are available.

Who qualifies for the Subsidized Rate?

The majority of students must qualify for free or reduced Lunch, or can provide documentation of other hardship, lack of access, etc.

My site needs additional financial support? What can I do?

On occasion, Skate Like a Girl has capacity to host extremely low cost or free clinics or programs in order to serve certain communities - please note this below & provide documentation if you can.

Rate Your Site Can Afford: *

$20 / program hour / participant (corporate/birthday rate) $10 / program hour / participant (school/community rate) $5 / program hour / participant (scholarship rate for groups in need)

Documentation of Need for Your Site

Enter the message as it's shown *