Skate Like a Girl Ongoing Program Partner Application

Skate Like a Girl Ongoing Program Partner Application
Thank you for your interest in partnering with Skate Like a Girl!

This form is for Schools (K-12), agencies (Youth-serving nonprofits, 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 a particular site.

If you are interested in Skate Like a Girl coming to your event or other one-day opportunity, This is not the correct form. For one-day events, please fill out our Event Partner Application.
Which Skate Like a Girl Chapter are You Looking to Partner With? *
ABOUT YOUR PROGRAM & SITE
Name of School, Agency or Group*
What day(s) work for your site to host Skate Like a Girl? (click all that apply)*

MondayTuesdayWednesdayThursdayFridayOther
Terms you are interested in having Skate like a Girl programs at your site: (click all that apply)*

Fall (September-December)Winter (January-March)Spring (April-June)Summer (July-August)Other
Program offerings you'd like for your site:*

One 1 hour long classOne 2 hour long classTwo, back to back, 1 hour classesOther
Class Start Time*
Class End time*
Please list the specific dates of the program, and include any skipped days (holidays)*
Example: January 8-March 1, skip January 21st.
Have We Offered This Program to Your Site in the Past?*

YESNOYes, but it was different/long time agoUnsure
Will we be charged a site fee for using your gym/program space?*

YESNOUnsure
Program Site Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact Name*

First NameLast Name
E-mail*

Confirmation Email
Phone Number*

Area CodePhone Number
NEEDS FOR YOUR PROGRAM SITE:
Gear Needed for Your Site (What You Need Skate Like a Girl to Provide)*

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

Yes, we do not have the ability to host registrationNo, we will do registration & give S.L.A.G. a roster of participantsUnsure
Do you need us to make a program flyer to help promote at your site?*

Yes, we would love that!No, we will take on marketing and promoting program sign up ourselvesUnsure
Do you require additional insurance (COI) from Skate Like a Girl?*

YesNoNot 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?*

YesNo
Any "Drop In" Participants?*

All participants will be "drop in"All participants will be pre-registered (on a roster)We will have both "drop in" and pre-registered participants
Number of Participants:*

5-1011-1516-20UnsureOther
Ages of Participants (Check All That Apply)*

K-5th grade6-9th grade10-12th grade18 years or older
Describe any special needs of your group and/or site:
Example: We have to share the skate space with the soccer group on rainy days, or some of our students are deaf or hard of hearing
WHAT YOUR PROGRAM SITE CAN PROVIDE:
Secure Gear Storage (approximately 4x4 ft; ex: storage closet, corner of secure classroom, etc.)*

Yes, we can provide a secure place to store gearNo, we cannot provide storageunsure
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 off-site skate parks/space)Other
Has the Skate Program Space Been Secured and Approved?*

Yes, we are approved to use the spaces/resources listed aboveNo, we have not gotten approval yet
Can Your Site Provide Snacks?*

Yes, we canNo, we cannotStudents provide their own snacksUnsure
Administrative Support (Check All That Apply)

Additional Staff and/or volunteer to support behavior management during class timeMake roster & give to Skate Like a Girl prior to start of classesCollect Skate Like a Girl waivers prior to start of classesSupport collection of demographic and other data for grant purposesUnsure
PRICING
Skate Like a Girl aims to eliminate any access barriers getting in the way of youth attending our classes. Therefore, we offer sliding scale rates for agencies and schools that work with youth that experience any of the following:
- qualify for free or reduced meal programs
- houselessness or financial instability
- face other barriers to access
Please describe the youth population that you are serving and if they experience any of the above barriers to access?*
The percentage of youth at your site that qualify for free &/or reduced meal programs:*
Program pricing ranges from $50-$350 per class depending on the needs of each school or agency. Does your school or agency have a budget for programming?*

YesNoOther
Please elaborate on your answer to the question above.*
Amount of Participants & Rate Your Site Can Afford:*

5-10 Youth ($39/class)5-10 Youth ($77/class)5-10 Youth ($155/class)11-20 Youth ($77/class)11-20 Youth ($155/class)11-20 Youth ($309/class)Other
If you selected "Other" please describe here:
Do you want youth to build their own skateboards (to keep) as part of this class? (may be additional charge)
Enter the message as it's shown*
Should be Empty:

Skate Like a Girl Ongoing Program Partner Application

ABOUT YOUR PROGRAM & SITE

NEEDS FOR YOUR PROGRAM SITE:

WHAT YOUR PROGRAM SITE CAN PROVIDE:

PRICING