Facility Request Form
Upon completion, this form must be submitted to the front desk at the Camp Hydaway or emailed to
camphydaway@liberty.edu. Fees will be determined upon completion of this form at the discretion of the Camp
Hydaway Staff. Requests must be submitted at least two weeks prior to the date requested. Completing this form
does not guarantee use of the facilities. For more information please contact Camp Hydaway at (434) 592-6284.
Date(s) Requested: ______________________________________________________________
Affiliation to Liberty University:
O
Staff/Faculty
O
O
Student
Other
Facility Requested:
Camp Hydaway:
O
O
O
O
O
Student Center Multipurpose Room
Pavilion
Bonfire Area
Kitchen
Woods Pavilion
Event Type: _____________________________________ Times: ____________________________________
Description of Event: ___________________________________________ # of Persons Attending: _________
Set-up Needs: _______________________________________________________________________________
____________________________________________________________________________________________________
The above organization agrees to (1) safeguard the facility and its furnishings, (2) return the facility to its original setting
following the event, and (3) dispose of trash properly. Furthermore, the organization agrees to reimburse Liberty University
for maintenance or housekeeping costs resulting from misuse of or damage to the facility.
Requestor (PRINT): ________________________________ Phone: _____________________________
Address: ________________________________________ Cell: _______________________________
City, State, Zip: __________________________________ Email: _____________________________
Signature: _______________________________________ Date: ______________________________
For Office Use Only: Manager’s Initials: _______
Amount Due: __________
Today’s Date: ____________
Date Paid: __________
Approval Signature: _________________________________
Time: ___________
Work Order #: _____________
Date: ___________________________