Skate PE & Afterschool programs Interest form

School / Organization

School / Organization Address

Program Type

Skate PE Afterschool Program other

First Name

Last Name

Phone Number

Email Address:

How often would you like classes to be held?

Daily Once per Week Twice per Week Other

How many days or weeks would you like the program to run?

Approximately how many children do you anticipate will participate?

Grade Level(s):

Program Discription

Additional Comments or Questions:

School Program Interest Form