Special Programs Request Form

Thank you for considering our services for your request! We are able to provide a variety of group fitness classes, lectures around physical activity and Campus Recreation services, and massage therapy options. If you ever have any questions, please reach out to Miranda Price at miranda.price@crc.gatech.edu.

Full Name of Requester*

Georgia Tech Email*

Phone Number*

This will be used as a contact point for the instructor/masseuse day of event.

Organization/Group Name*

Affiliation of Participants*

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Which services are you requesting?*

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What type of fitness class are you requesting?

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What on campus location would host the program?*

Are all of your group participants CRC Members?*

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Preferred Day of Your Event*

Please remember, this date is not a guarantee, but we always strive to meet the request!

Time of event*

Please include start and finish time of your event.

*Please note travel/set up/break down time may be added to the event bill.

Is this a reoccuring program request?*

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How often would you like your program to occur?

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Brief description of event*

Account Information for Billing*

$50/ hour (including set up and tear down time)

$30 fee per additional instructor or masseuse needed

Please list your Georgia Tech work tag information for billing purposes in the event payment is not received within 21 days of your event.

Terms and Conditions*

All program requests must be made at minimum 21 calendar days prior to proposed event date to be considered for approval. Events consisting of any guests not affiliated to Georgia Tech (students, faculty, approved organizations, etc.) must be declared in advance. Note: If a request includes external participants, you MUST check External Group/Guests. Failure to acknowledge/indicate this can result in the cancellation of your reservation. Requests are received and approved on a first come, first serve basis after Campus Recreation programming needs are filled. Event requests for non-university related individuals must adhere to additional requirements and procedures per university regulations. Due to safety and liability concerns, additional insurance and increased supervision may apply. The need for chaperones will be required (due to age restrictions) for special events in Campus Recreation Facilities involving minors and/or anticipated guests. Please note: this form is for making a request only. Completion of the form does not guarantee approval of your request or confirmation staffing. The Requestor will be notified by email of the approval / denial of the request once it is reviewed. Fees vary based on university affiliation and direct costs needed to support the event/activity. Charges for facilities, set-up, clean-up, staffing and/or equipment may apply to each event and must be understood and agreed upon prior to the reservation confirmation being finalized.

Do you agree to the Terms and Conditions?

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