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 unless otherwise posted.
First & Last Name of Person making request *
Organization
email *
Purpose *
Gym Choice *
Start Date *
MM
/
DD
/
YYYY
Is your Event Repeated? (If Yes, Monthly, Weekly). What date will it end?
Start Time *
Time
:
End Time *
Time
:
Any other information?
By submitting this form, I agree to leave the facility clean, picked up, any items used will be returned to it's place, all lights will be turned off before leaving, no doors will be propped open and be sure they are all shut before leaving the school property. Failure to follow these items may result in restricting use of the facility in the future. *
Required
Contact Information
Casey Loomis
303 West Church Street
Pleasanton NE, 68866
Phone Number: 308-388-2041
email: cloomis@pleasantonbulldogs.org
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