Safety Program Intake Form

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Interested in applying to the safety program? Complete this short intake form to tell us about your organization, and we'll reply with step-by-step instructions on how to get started with the application and an estimated cost.

Email *

First and Last Name *

Phone Number

Name of Organization *

Organization Website *

I have my own facility and NO other circus activities happen in my space other than my program. *

Yes

I have my own facility and other circus activities happen in my space other than my program. *

Yes

I rent space in a facility where non circus activities also happen (concurrently or not): gymnastics, yoga, fitness space. *

Yes

I travel among different facilities for my program. *

Yes

I offer an in house aerial teacher training program intended to enable my students to develop into members of my aerial teaching staff. *

Yes

I offer aerial teacher training courses, at my own facility and/or others. *

Yes

I hire teachers with pre existing qualifications. *

Yes

I offer continuing education to my staff. For the purpose of this form, we define ongoing education for existing staff as building on an existing body of knowledge and experience rather than training or giving knowledge from scratch. Example: Offering tumbling training to a staff of areal teachers is not ongoing education. Offering a guest workshop for teachers to expand their vocabulary of material is ongoing education. *

Yes

Please let us know the approximate number of program teaching hours each week. Program teaching hours can be analogous to classes offered or lead coaching hours. This is estimated so do your best! *

0-15

15-45

45-100

100+

Summer Programs: for the purpose of this form, 6hrs or more constitutes a full day. Anything less than 6hrs constitutes a partial day. *

I have a full day summer camp program that includes aerial apparatuses

I have a full day summer camp program that does not include aerial apparatuses

I have a partial day summer camp program that includes aerial apparatuses

I have a partial day summer camp program that does not include aerial apparatuses

I do not have a summer camp program

Number of unique students per week (approximately): *

1-49

50-100

100+

Please tell us anything else you think we should know about your organization.

A copy of your responses will be emailed to the address you provided.

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