Facilities Usage Request - External Organizations

This form should be completed by any external organization requesting usage of Waynesburg University facilities.
Completing this form does not guarantee approval of the event. All requests are reviewed and the contact person will be notified as to approval or denial of request.

Groups approved to use facilities MUST provide Waynesburg University with a Certificate of Insurance in advance of event.

Organization/Group Requesting Facilities Use
Name of Primary Contact Person from Organization Name of Primary Contact Person from Organization First Last
Phone for Primary Contact Person Phone for Primary Contact Person - ### - ### ####
Email for Primary Contact Person from Organization
Organization's Business Address Organization's Business Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Detailed Description of Event to be Held (including schedule if multiple dates needed)
Is This Event In Conjunction With The University?

Is This Event In Conjunction With The University? Yes No
I am a

I am a WU Staff/Faculty WU Alumnus Other Other
Name of University Staff Member Contact Name of University Staff Member Contact First Last
Email of University Staff Member Contact
Year of Graduation from WU and type of degree
Facilities You Are Requesting to Use
Other Facility description
Maximum of 10 words allowed. Currently Entered: 0 words.
Athletic Facilities - additional (check all that apply)

Athletic Facilities - additional (check all that apply) Wiley Stadium Baseball/Softball Field (Turf) Softball Field(s) - (Grass) Marisa Fieldhouse/Gymnasium Tennis Courts Restrooms Scoreboard Concessions Parking Locker Rooms Water eSports Arena Wiley Armory - wrestling room Other Other
First Choice Date Requested First Choice Date Requested / MM / DD YYYY
Time(s) Requested
Alternate Date Request Alternate Date Request / MM / DD YYYY
Date(s) / Time (s) Required for Preparation
Expected Number of Attendees
Needs/Special Requests:

Needs/Special Requests: Event Plans To Have Food Media Services (Technology: computer, screen, projector, podium/microphone, other AV, etc.) Tables/chairs/special set-ups Other Other

Aladdin Dining Services Must Be Used For Food at WU Facilities
Media Services - specifics

Media Services - specifics Screen & Projector Computer access Tech Support Podium & Microphone Wifi Access Other Other
eSports Room Needs. Please describe in detail the following: 1. software to be used, 2. number of competitors/computers to be used, 3. multimedia needs for the event, 4. Name and contact info of coach(es) who will be in attendance for your team(s).
In advance of the event, you may be asked to come to campus to work with our eSports Director and make sure all devices are operating as expected.
Additional Questions, Comments, or Pertinent Information about your request:
Name of Head of Your Organization
Certificate of Liability Insurance

Certificate of Liability Insurance I agree and am able to submit a Certificate of Liability for my event I am unable to provide a Certificate of Liability for my event Not applicable to this event
You may upload your certificate of coverage here or email it once reservation is confirmed as booked.

Attach Files
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