Gym/Coach Grant Application

1
Your Name* This field is required.
First Name
Last Name
2
Gym or Business Name:If you don't own the business, list where you work out of:
3
Business Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
United States
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
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Aruba
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The Bahamas
Bahrain
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Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
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Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
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Falkland Islands
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France
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The Gambia
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Laos
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Liberia
Libya
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Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
4
Work Phone Number* This field is required.
Please enter a valid phone number.
5
Work Email* This field is required.
example@example.com
6
Instagram Handle (Business or Gym, not personal)
7
What do you know about Compete for a Cure?
8
Do you subscribe to the Compete for a Cure Email list?
Yes
No
9
Would you be willing to share your community story/journey with the Compete for a Cure Community?
Yes
No
10
Do you know about our Boob University?boobuniversity.com
Yes
No
11
Would you be willing to learn more about our Free Course: Breast Cancer Basics for Coaches?
Yes
No
12
Would you be willing to learn more about our Free Course: Breast Cancer Basics for Women?
Yes
No
13
Do you currently partner with any local Oncology centers?* This field is required.
14
Have you ever worked with a breast cancer survivor or do you have survivors in your community?
Yes
No
15
Do you currently offer professional treatment or coaching for movement and/or recovery, specifically for survivors?
Yes
No
16
What style of coaching do you offer? (Boot Camp, Nutrition, Yoga, Hyrox, Spartan, CrossFit, etc)
17
Do you wish there was more information on anything specific in regards to health and wellness for cancer patients? Whether it be local resources, online education, how to connect with survivors, etc.
If we are aware of the community's requirements, it enables us to prioritize specific education and allocate resources accordingly.
18
How much financial help do you need for helping the survivors in your community? * This field is required.We aim to provide a min of 3 months of financial support and meet you wherever you are in your journey.
19
Lastly, please tell us why you are applying for a Grant, what the funds will go towards, and how it will help survivors in your community* This field is required.If you currently work with survivors, this is where you can tell us how we can help ensure your community is helping survivors Thrive After Diagnosis! If you do not have any survivors, is there a need in your community but you lack finances to make it happen? Fill us in!
The more details the better
20
In the event that we find any falsified information on your funding application or any deliberate omission related to Compete for a Cure Fund, you will be obligated to promptly reimburse Compete for a Cure for any payments that were provided on your behalf. Moreover, Compete for a Cure reserves the right to suspend any further payments that may have been previously awarded to you.
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