Virtual Fitness Form
Thank you for your interest in bringing wellness to your organization. Let us deliver fitness to next event or customize videos for your organization. Please fill out the form so we can best serve you.

Number of Instructors: 5
Classes Offered: Mindfulness, Flexibility, Cardio, Strength, Pilates, and Dance

Fusion Fitness by Jelyse LLC
info@fusionfitnessbyjelyse.com
www.fusionfitnessbyjelyse.com
Contact Name & Phone Number *
Contact Email Address *
Organization *
Event Name
Event Date
MM
/
DD
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YYYY
Event Time
Time
:
Describe the participants (select multiple if needed) *
Required
Estimated number of participants. *
What is their gender (select multiple if needed)? *
Required
What type of fitness class would you like (select multiple if desired)? *
Required
What equipment do your participants have access to?
I acknowledge that participants will need to sign a waiver before the session releasing all liability from fitness instructor. *
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