Equipment request Pick-Up Date MM slash DD slash YYYY Pick-Up Time : Hours Minutes AM PM AM/PM Return Date MM slash DD slash YYYY Return Time : Hours Minutes AM PM 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 Requested Equipment Requested Equipment Requested Equipment Requested Statement 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.