UCSD FitLife Mobile: Request Form
FitLife Mobile brings fitness & wellness programs to you! 

A three week request lead time is required for all Classes and Workshops. 

For multiple requests, please submit each request in a separate entry. 

 For information on pricing please visit our website at: https://recreation.ucsd.edu/services/fitlife-mobile/ 
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Contact Email *
Group/Organization *
Will the participants be....
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Contact Name *
Contact Phone Number *
(xxx) xxx-xxx
Recurring Fitness, Yoga, & Pilates (three+ consecutive weeks of classes to qualify)
One-Time Fitness, Yoga, or Pilates class
Wellness Workshop
Class or Service Day(s) and Times *
Example: M, W | 12-1PM
Location *
Building & Room (Class location must be secured before contract start date)- For Virtual Class, type "Zoom"
Instructor *
If you're not sure, write TBD.
Contract Length - Start Date *
MM
/
DD
/
YYYY
Contract Length - End Date *
MM
/
DD
/
YYYY
Holidays *
If none, write N/A
Payment Type *
Additional Comments
Thank you!
We will respond to this request within 3 business days.
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