Fitness on the Fly Request Form

*Group Name

*Requester's Name

*Requester's Phone Number

*Requester's Email Address

Requester's KSU ID Number (if applicable)

*Requester's Affiliation with KSU

If you selected other, please list your affiliation here

If different than the requester, what is the information for the on-site contact person on the day of the event:

Name

Phone Number

Email Address

*Group Type

Registered Student OrganizationAcademic ClassDepartmentOther

If you selected other, please list your group type here

Program Description

Is this a one time request or a series of programs?

One TimeSeries

If a series, how many?

*Is this a stand-alone program or part of an overall larger event?

Stand-alonePart of overall larger event

*Desired Program Date(s)

These dates must be at least 4 weeks out from today’s date. We will do our best to accommodate your priority date.

*Number of participants

Minimum of 5 people. Please note that program prices are based on a specific participant to instructor ratio. If the number of expected participants exceeds this ratio, you may be quoted for additional staff to maintain program quality and safety protocols.

*Age of participants. Select all that apply.

*Requested Duration of program

*60-minute minimum

*Preferred start and end time for the program

We will do our best to accommodate your requested time.

*Activity Location

Student Recreation and Activities Center, 肉肉传媒 CampusRecreation and Wellness Center, Marietta CampusOther on-campus location

If other, please specify campus, building, and room number

Please note, for locations outside of our Sports and Recreation facilities, it is the requester’s responsibility to reserve space. Space reservation confirmation will be requested.

Class Format Options

Yoga Class $40/hour (inside Sports and Rec Facility)Yoga Class $50/hour (outside Sports and Rec Facility)Zumba Class $40/hour (inside Sports and Rec Facility)Zumba Class $50/hour (outside Sports and Rec Facility)Strength and Conditioning Class $55/hour (includes cost of equipment)Cycling Class $55/hour (includes cost of equipment)Other

Add-on Options

If other, please specify

*What is the funding source?

Registered Student OrganizationKSU DepartmentOther

*What is the payment method?

If paying via KSU Owl Pay, you MUST complete the following:

Department ID Number

Department Head Name

Department Head Email

Business Manager Name

Business Manager Email

Organization Advisor Name (if applicable)

Organization Advisor Email (if applicable)

How did you hear about this program?

If other, please specify where you heard about this program

*By clicking this box, I agree to abide by the Fitness on the Fly Program guidelines listed below.

I agree.

肉肉传媒

Group and Contact Information