Booking Request Form
Submit your team information below and the staff of Escape Hampden-Sydney will contact you to schedule your escape attempt. Fields with an asterisk are required. A team names is not required at this time but will need to be provided prior to attempting the Escape Room.

A team consists of four people (some exceptions may be made for small children) with a donation of $10/person for students, and $15/person for all others. A copy of the waiver and escape room rules can be found here: http://libguides.hsc.edu/escapeHSC

Please direct questions about this form to: mconnolly-brown@hsc.edu

Team name:
Your answer
Team captain/primary contact [first and last name]:
Your answer
Team captain/primary contact email:
Your answer
Team captain donation amount ($10.00 for students, $15.00 for non-students. More is gratefully appreciated! Donations go to HSC and are tax deductible.):
Team captain's address (for receipt of donation):
Your answer
The team captain/primary contact is:
Team member #2 [first and last name]:
Your answer
Team member #2 email:
Your answer
Team member #2's donation amount ($10.00 for students, $15.00 for non-students. More is gratefully appreciated! Donations go to HSC and are tax deductible.):
Team member #2's address (for receipt of donation):
Your answer
Team member #2 is:
Team member #3 [first and last name]:
Your answer
Team member #3 email:
Your answer
Team member #3's donation amount ($10.00 for students, $15.00 for non-students. More is gratefully appreciated! Donations go to HSC and are tax deductible.):
Team member #3's address (for receipt of donation):
Your answer
Team member #3 is:
Team member #4 [first and last name]:
Your answer
Team member #4 email:
Your answer
Team member #4's donation amount ($10.00 for students, $15.00 for non-students. More is gratefully appreciated! Donations go to HSC and are tax deductible.):
Team member #4's address (for receipt of donation):
Your answer
Team member #4 is:
Indicate your day and time preference. Please note that indicating preference does not imply a guarantee that preferred time slot will be available. As a general rule, Escape Room attempts will only be schedule during normal library hours (found here: http://libguides.hsc.edu/library) and will depend on the availability of Escape HSC staff.
Special requests or circumstances?
Your answer
Team captains are responsible for having the entire team present for the Escape Room event on time. Donations are due prior to running the event and may be cash or check payable to “H-SC”. Receipts for charitable donations will be sent from the Office of Institutional Advancement. Scheduling is first come, first served, with the exception that H-SC students always have priority.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms