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- Host a Certification
Please answer all questions below
City, State, Zip and or Country
Local Contact who is doing local marketing and research, social media, community outreach etc...
(Please leave blank if same as above or you are not sure)
Do you have a dedicated space that can accommodate 25-30 people for lecture and practical training?
Do you have audio visual equipment (screen, projector)?
Do you have the following equipment or will you have before hosting the event?
(Please check equipment that you have)
(1) 2 lb. Dynamax Medball
(1) 4 lb. Sandbell
(1) 6 lb. Sandbell
(1) 8 lb. Sandbell
(1) 20 lb. Sandbell
(2) Blue 12" cones
(2) Green 12" cones
(2) Purple 12" cones
(2) Red 12" cones
(2) Yellow 12" cones
(2) 1 1/4” Superbands
(2) 3 1/2” Superbands
(8) First Place Adjustable Banana Step
(1) 40' First Place 1" Training Rope
(1) Set of Agility Rings
If you do not have any or all of the above equipment, will you be willing to purchase the Autism Fitness Package from Perform Better?
Are you currently running any ASD or Adaptive Fitness programs?
Are you planning on creating a program for ASD?
Which age groups?
Select All that Apply
Elementary K-5 (ages 5-10)
Middle school Grade 6-8 (ages 11-13)
High School Grade 9-12 (ages 14-18)
All of The Above
Additional Information or Message
View How to Host a Site (pdf)
View Sample Contract (pdf)
Little Neck, NY
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