Healthy Living Staff - Pre-Class Supply Request Form

Trainer Name (First & Last)

Trainer/Instructor Preferred Phone #

Trainer/Instructor Preferred Email

Class Name

Date & Time of Class

Location of Class

Studio A

Studio B (Cycle Studio)

Studio C

Strength Center

Cardio Room

Gym A/B

Outside/Pavilion

None of the above

Expected Number of Participants

Equipment Request

Equipment →	Specific Item & Quantity
Cardio Equipment (bikes, treadmills, etc.) →	Cardio Equipment (bikes, treadmills, etc.) Please define the specific type of item & amount needed of this selection.
Free Weights (dumbbells, kettlebells, etc.) →	Free Weights (dumbbells, kettlebells, etc.) Please define the specific type of item & amount needed of this selection.
Resistance Bands/Tubes →	Resistance Bands/Tubes Please define the specific type of item & amount needed of this selection.
Mats (yoga, exercise, foam) →	Mats (yoga, exercise, foam) Please define the specific type of item & amount needed of this selection.
Stability/BOSU Balls →	Stability/BOSU Balls Please define the specific type of item & amount needed of this selection.
Medicine/Slam Balls →	Medicine/Slam Balls Please define the specific type of item & amount needed of this selection.
Benches/Step Platforms →	Benches/Step Platforms Please define the specific type of item & amount needed of this selection.
Cables/Pulleys/Machines →	Cables/Pulleys/Machines Please define the specific type of item & amount needed of this selection.
Speaker →	Speaker Please define the specific type of item & amount needed of this selection.
Microphone →	Microphone Please define the specific type of item & amount needed of this selection.
Projector/Screen/TV →	Projector/Screen/TV Please define the specific type of item & amount needed of this selection.
Whiteboard/Markers →	Whiteboard/Markers Please define the specific type of item & amount needed of this selection.
Handouts/Printed Materials →	Handouts/Printed Materials Please define the specific type of item & amount needed of this selection.
Nutrition/Program Supplies →	Nutrition/Program Supplies Please define the specific type of item & amount needed of this selection.
First Aid/Safety Equipment →	First Aid/Safety Equipment Please define the specific type of item & amount needed of this selection.
Other →	Other Please define the specific type of item & amount needed of this selection.

Additional Setup Needs

Room Layout/Arrangement Notes