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Thank you for your interest in the Gym at Northwest. While we have currently maxed out our facilities usage, we are always open for new partnerships as the opportunity presents itself. Please fill out the following questions completely and a member of our team will reach out to you shortly. 

First Group Leader's Name

First Name*

Last Name*

Phone*
First Group Leader's Age Acknowledgment*
First Group Leader's Date of Birth*
I certify that I am 18 years of age or older
First Group Leader's Signature*
Second Group Leader's Name

First Name*

Last Name*
Second Group Leader's Date of Birth*
Third Group Leader's Name

First Name*

Last Name*
Third Group Leader's Date of Birth*
Fourth Group Leader's Name

First Name*

Last Name*
Fourth Group Leader's Date of Birth*
Fifth Group Leader's Name

First Name*

Last Name*
Fifth Group Leader's Date of Birth*
Sixth Group Leader's Name

First Name*

Last Name*
Sixth Group Leader's Date of Birth*
Seventh Group Leader's Name

First Name*

Last Name*
Seventh Group Leader's Date of Birth*
Eighth Group Leader's Name

First Name*

Last Name*
Eighth Group Leader's Date of Birth*
Ninth Group Leader's Name

First Name*

Last Name*
Ninth Group Leader's Date of Birth*
Tenth Group Leader's Name

First Name*

Last Name*
Tenth Group Leader's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Scheduling Details
Please select the facility resource you are interested in.*
Basketball Court
Cardio & Weight Room
Sand Volley Ball Court

Please describe your desire for partnering with The Gym at Northwest. Be sure to include the team or organization's name, the size of your group, the age range of those who will be participating, and any additional information you feel is related. *

Please list the desired date(s) and time(s) you are requesting. *
Will this be a repeated event?*
No
Yes

Please list the main location of your group.
Are you currently affiliated with Northwest Bible Church?*
No
Yes
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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