Custom Fitness Request Sheet

Custom Fitness Request Sheet

Organization or Group Information

Organization or Group Name*

Campus Affiliation*

Campus Group

Student Org

3rd Party Rental

Number of Attendees*

First & Last Name of Contact Person*

*must be responsible for payment

Contact Email*

*email to receive invoice upon approval of request

Request Information

Type of Request*

Custom Fitness Class or Program

Requested Program*

Boxing

Cycling

Barre

Pilates

Yoga

Dance

Cross training

Sculpt

Aqua

Jump fitness

Other

Description *

Level of Difficulty

Beginner

Moderate

Advanced

Please provide description of your programming request*

include details on location & activity type

Special Music/Choreography

Yes

No

Preferred Location

Select or enter value

Requested. Date*

1st. Alternate Date

2nd Alternate Date

Start Time*

*Specify AM/ PM

End Time*

*Specify AM/ PM

Comments or Questions

Billing Information

A cost estimate will be provided to you for any approved event. Please Note:

Card or Check payment method will be required two weeks in advance of your event
PG #/Worktag/ Grant # or Customer Account # for Accounts Recievable Billing will required the billing information at the time of request to be billed within 1-3 business days of your event.

Payment Method*

Select or enter value

Billing Information*

Please provide PG#/ Worktag/ Grant # or Customer Account # to reserve your program or rental.

Send me a copy of my responses

Powered by

Privacy Notice|Report Abuse