Equipment Request Pick-Up Date Date Format: MM slash DD slash YYYY Pick-Up Time : HH MM AM PM Return Date Date Format: MM slash DD slash YYYY Return Time : HH MM AM PM Responsible Staff (First Name | Last Name)*Responsible Staff Phone Number*Use (###) ###-#### format.Responsible Staff UTK Email Address* Please provide the email address for the Responsible UTK Staff member named above.Organization*Contact Phone Number*Name of Event*Location of Event*Pick-Up Person (First Name | Last Name)*Returned by: (First Name | Last Name)*Equipment RequestedEquipment RequestedEquipment RequestedEquipment RequestedStatement of Liability I understand that I/my organization will be liable for loss, theft or damage of equipment. Name* First Last NameThis field is for validation purposes and should be left unchanged.