Fitness Consult Request Form

The Process: Once your form is received, a Fitness Center staff member will send (to your HCC address) an appointment request that includes additional instructions. Please allow three (3) business days to process.

So that we may best serve you, please provide the following information:

Name:
HCC Email:
(Ex. jsmith@harford.edu)
Phone Number:
(xxx-xxx-xxxx)
Other Phone:
(xxx-xxx-xxxx)
Briefly describe your fitness program goals: (Ex: Improve cardiovascular fitness, build muscle, etc...)
RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT
I have read and fully understand this release of liability and assumption of risk agreement. I acknowledge that I am signing the agreement freely and voluntarily, and intend by my signature to be a complete and unconditional release of all liability.
   

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