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Facility Use Application

  1. Meeting Details
  2. Government Center rooms are only available Monday - Thursday.

  3. All meetings must end by 10pm.
  4. Do you plan to serve refreshments?*

    Food/drink are only permitted in certain rooms.

  5. Is this a public meeting (open to any member of the public to attend) or closed meeting (limited to invited guests only)?*
  6. If you intend to put up signage or hand out flyers, please include examples.

  7. Agreement

    I accept liability and hereby agree to indemnify and hold harmless Loudoun County, Virginia, its officers, agents and all employees and volunteers, from any and all claims for bodily injury, personal injury, and/or property damage in connection with the use of the facility. I accept responsibility for control of the area until the meeting is finished. I accept responsibility for complying with all Americans with Disabilities Act (ADA) requirements. I recognize that it is my responsibility to supply ADA required assistance for this event. I have read and agree to comply with the “Facility Use Policy.” The undersigned hereby certifies that he/she is authorized to execute this document on behalf of the organization requesting the use of the facility.

  8. Facility Use Policy*
  9. By typing your name in this box, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this form.
  10. Confirmation
    Your request will be reviewed and processed by county staff. You will receive an email to confirm your reservation.
  11. Leave This Blank:

  12. This field is not part of the form submission.