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PFP Instructor Interest Form

Before completing the form below, please review the requirements for participants, locations, equipment, and instructors which can be found in our Getting Started Guide.

1. Please enter your contact information below:  *This question is required.
2. Are you currently employed as an instructor at a local gym, YMCA, recreation center, or other community center?  *This question is required.
3. How would you describe your knowledge of Parkinson’s?  *This question is required.
4. Have you already secured a gym, YMCA, recreation center, or other community center that is willing to host a Pedaling for Parkinson’s class?  *This question is required.
5.

Does the facility you plan to hold your class in have enough appropriate stationary bikes you will be able to use? 

5. Does the facility you plan to hold your class in provide insurance and waivers for participants that will cover your class? 
5. Does the facility you plan to hold your class in require a paid membership or other fee for participants? 
5. Will the facility you are working with provide compensation to you to teach the class? 
5. Do you have interest from participants already?  *This question is required.