No Hit Zone | Register your No Hit Zone Location

Name(Required)

First Last

Email(Required)

Phone(Required)

What type of organization are you associated with? (Check all that apply)(Required)

Other organization you're associated with? (optional)

What barriers have you encountered or anticipate encountering in establishing a No Hit Zone?(Required)

Cost of Signage and Parent Alternative Materials

Lack of Administration support

Staff resources to implement

Fears about negative feedback

Need for staff training

Other

Enter the barrier you are facing below.(Required)

What concerns do you have about implementing No Hit Zone? (Optional)

Is your organization already a No Hit Zone (have policy and signage already in place)?(Required)

Yes

What is your organization's name?(Required)

When was No Hit Zone established/implemented at your organization? (optional)

Is your organization in partnership or being led by another organization or individual to become a No Hit Zone? (If yes, please answer with who).(Required)

Yes

Who are you in partnership with?(Required)

Please let us know a little about your No Hit Zone. Which of the following do you have?(Required)

Would you like to share your signage and materials with others? If so, please upload your documents below, which may be added to the website. (optional)

Max. file size: 128 MB.

Where is the main organization located? (Enter address that you wish to have on the No Hit Zone Map)(Required)

Street Address City State / Province / Region ZIP / Postal Code Country

If your organization has signage in more than one location, please enter the number of locations below.

NOTE: Please consider making a separate entry for each location, so that all locations will be on the map. (Note: you will be entering your map locations on the next screen, after you click submit, on this form.)

What assistance do you currently need?

Do you have any questions or concerns? (optional)

Which level best describes your No Hit Zone (NHZ)? (optional)

Level 1: Conceptional Phase: At least one person is starting to formulate a plan on how the organization can implement the NHZ concept, this lead person has discussed creating a NHZ with other colleagues within their organization, and/or have attended a NHZ presentation and/or established communication with other NHZs

Level 2: In Process: More than one person working on the concept, working on an implementation plan to develop materials and training, gained support for implementation from organizational leadership, and/or communication with other NHZs (e.g. listserve)

Level 3: Basic: Training underway for personnel, on-going training plan, and/or signage and other notification that the facility/organization is a NHZ

Level 4: Comprehensive: Established training of all staff and training for new staff., prominent signage and notification that the facility/organization is a NHZ, at least one person has NHZ as part of their job description, and/or community awareness that facility is a NHZ

Level 5: Regional: Established organized training of all staff and training for new staff, prominent signage and notification that the facility/organization is a NHZ, at least one person has NHZ as part of their job description, community awareness that facility/organization is a NHZ, provides outreach education about NHZ, enlists other organizations in the community/region to be a NHZ, resource center for NHZ, and/or leadership in prevention

How did you hear about the No Hit Zone initiative?(Required)

(PLEASE STAY ON THIS PAGE AFTER YOU CLICK SUBMIT) To be added to the No Hit Zone map, confirm that you will need to fill out the next form you'll be redirected to after you submit this.(Required)

Confirm

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NHZ agency/location name
NHZ location (Type full address and select from Google Map prompts)
List your organization type(s) to be displayed on map
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