Existing Affiliate Application form

Existing Affiliate Coach Application Form

What RSB affiliate are you associated with?(Required)

Please Choice One Training Option:(Required)

Select One Training Date/Location:(Required)

Prospective Coach Name:(Required)

Prospective Coach Address:(Required)

Prospective Coach Email:(Required)

Prospective Coach Phone Number:(Required)

Prospective Coach Shirt Size:(Required)

Trainees completing Online & In-Person Training, Online Only Training, and In-Person Only Training must hold one of the following requirements: Hold and maintain a professional certification as a Personal Trainer through the American College of Sports Medicine (ACSM), the National Academy of Sports Medicine (NASM), OR other nationally accredited organization recognized by the RSB Board for this purpose; Hold and maintain formal licensure or certification as a Physical Therapist or Occupational Therapist, under the issuing authority of any State or Province; Hold a formal undergraduate degree in a health-related field from an accredited academic institution.(Required)

Comments

This field is for validation purposes and should be left unchanged.

Δ

Back

Fighting Back Against Parkinson's

Rock Steady Boxing
HQ Gym, Affiliate & Administrative Offices
6847 Hillsdale Court
Indianapolis, IN 46250
Email: info@rocksteadyboxing.org

317-288-7035

hqgym@rocksteadyboxing.org

DONATE