Shippensburg University Office of Housing and Residence Life Initiatives Program Order Form
First & Last Name Date of event:
Name of organization Number of People
Set up/pick up time
[None] Start Time of Event:
What areas do you feel your group needs growth in? (You may check more than one area and/or sub area):
Do you need a facilitator?
If yes, please provide additional dates and times of availability.
Does your group need any special accommodations?
If yes, please explain.
Contact Information (This is the preliminary contact person who will be responsible for the pick, return, and care of Shippensburg University Initiatives materials)
Email Organization Advisor
Terms of Agreement: Shippensburg University Office
of Housing and Residence Life Initiatives Program is designed to help
organization grow in areas of development and strengthen bonds between
individuals. It is our hope that these tools and games will provide your group
with the support and growth requested. Please not the following terms and
conditions in using the program:
is the number one priority of the Initiatives Program. Please note that the
Initiatives Program is not responsible for any injuries sustained during an
initiatives game, (im)proper use of materials, and/or any other circumstance
where a participant may be injured.
is the responsibility of the customer to ensure that all equipment and/or
materials is returned to the Shippensburg University Office of Housing and
Residence Life Initiatives Program in the state which it was borrowed.
3.) In the event that equipment and/or materials
is not returned or damaged beyond repair, responsibility will fall on the
individual requesting the material or the organization for which they are
representing to replace said items.
Initiatives Program has the right to deny certain materials and/or activities
to customers in the event that they feel the customer’s safety is at risk.
Initiatives Programs may provide a facilitator upon request or train
individuals within the organization to facilitate programs. Please understand
that we have a limited number of facilitators and are requesting a two week notice for need of facilitators.
facilitators, and locations are subject to change in the event that one or more
of these cannot be provided.
the event that you need to cancel your appointment, it is the customer’s
responsibility to notify the Initiatives Program as soon as possible.
By checking this box I hereby understand
and accept all terms and agreements
Electronic Signature Date: