Pleasanton Gym Request Form
Form must be completed and approved prior to gym use for individuals and/or organizations. All gyms are closed to the public Monday through Friday 6am-6:30pm from August 8, 2017 to May 25, 2018 unless otherwise posted.
Name of person making Request *
Your answer
Name of Organization using facility
Your answer
email *
Your answer
Phone Number *
Your answer
Address *
Your answer
Purpose *
Your answer
Gym Choice *
Date *
MM
/
DD
/
YYYY
Is your Event Repeated? (If Yes, Monthly, Weekly). What date will it end?
Your answer
Start Time *
Time
:
End Time *
Time
:
Contact Information
Casey Loomis
303 West Church Street
Pleasanton NE, 68866
Phone Number: 308-388-2041
email: cloomis@pleasantonbulldogs.org
Submit
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