SNACK Free Trial Request (Virtual Classes)
Thanks for your interest in SNACK! Please complete the required questions on this brief form. Someone from our organization will reach you by email to answer any questions and assist with scheduling a free trial class.
* Required
Email address
*
Your email
First Name (Parent/Guardian)
*
Your answer
Last Name (Parent/Guardian)
*
Your answer
Cell Phone # of Parent/Guardian
*
Your answer
First Name (Child/Participant)
*
Your answer
Last Name (Child/Participant)
*
Your answer
Current age of child/participant
*
Your answer
Please select one class that you would like to try first.
*
Art
Dance
Exercise
Music
Yoga
Please select the preferred time for the child/participant to participate in SNACK classes.
*
Weekday AM
Weekday PM
Weekend AM
Weekend PM
Required
(optional) Our usual in-person schedule is currently suspended. When we resume, are you interested in attending classes in-person at our facilities on E 53rd St?
Yes
No
Clear selection
(optional) Are you seeking reimbursement through self direction? If so, please let us know the details including your agency/fiscal intermediary.
Your answer
(optional) Our weekly virtual classes are currently $30 each. If you are currently unable to afford this rate, please enter an amount that you would be able to pay per class.
Your answer
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