To download an application

							Prince William Forest Park
                                                                                               National Park Service
                                                                                               U.S. Department of the Interior

                                                                                               Prince William Forest Park
                                                                                               Triangle, VA



                                             Application for Use of the
                                           Telegraph Road Picnic Pavilion
Thank you for choosing Prince William Forest Park!

To ensure an easy processing of your application, please read and complete this application thoroughly. Your
application will not be processed if signatures are left incomplete or if either page is missing from your
application package.

The Application Process:
Applications are processed in the order they are received. If we can accommodate your request, a permit will be mailed back to you
confirming the date of your reservation. All vehicles entering the park to use the Telegraph Pavilion must have a copy of the permit displayed
on their dashboard. Please note that your reservation permit does not include the park’s $5.00 per vehicle entrance fee (good for 7
consecutive days) paid upon arrival.

A non-refundable fee of $80.00 must be included in your application.

The Pavilion:
The Telegraph Road Picnic Pavilion is a thirty-foot by twenty-foot covered pavilion with twelve picnic tables (six of them wheelchair
accessible), six cooking grills and electric outlets. It is adjacent to a comfort station with food-service sinks and flush toilets and there is easy
wheelchair access to the pavilion from the picnic area's 73 parking spaces. There are approximately twenty additional picnic tables scattered
throughout the adjoining woods of Telegraph Road Picnic Area - most with their own grills. A short path leads to the spacious William's
Ballfield (available first-come, first-served), which is suitable for softball, Frisbee or other activities.

Pavilion Availability:
Telegraph Road Picnic Pavilion and comfort stations are closed for the winter season from November through Mid-April. Please note that the
pavilion is only available from sunrise to sunset. No overnight facilities are available at the Telegraph Road Picnic Pavilion.

Emergencies and Safety:
If an emergency occurs while you are using the Telegraph Road Picnic Pavilion, contact the nearest park ranger on duty or call the National
Park Service Emergency Dispatch Center at 1-866-677-6677 or 9-1-1 using the payphone located in the Telegraph Road Picnic Pavilion
Parking lot. Both of these numbers are located on the payphone. Park Rangers are available at the visitor center every day from 9:00 am to
5:00 pm, except Thanksgiving, Christmas Day and New Years Day.

Trash-Free Park:
Prince William Forest Park has proudly adopted a “trash-free park” policy. Under the “trash-free park” guidelines, all trash receptacles have
been removed from the pavilion areas. Visitors are now asked to take their refuse with them when they depart, leaving a “trash-free park.”
For visitor convenience, the park provides empty refuse bags at the visitor center and entrance station.

Ranger-led Programs:
We invited you to participate in Ranger-led activities in Prince William Forest Park. The park offers both scheduled programs (i.e. – hikes,
campfire programs) as well as curriculum-based education activities. For more information, please contact the visitor center at 703-221-7181
or visit our website at www.nps.gov/prwi.

I hereby state that I have read and understand the above rules and regulations and understand that I am responsible for insuring the
permitted group’s compliance to the rules and regulations of the National Park Service. Violation of National Park regulations is a
violation of Federal Law and may result in eviction from the park, fines or mandatory appearance in Federal Court.




                                                                         Applicant Signature                                      Date

                                                                                                                                                 1
Prince William Forest Park
                                                                                               National Park Service
                                                                                               U.S. Department of the Interior

                                                                                               Prince William Forest Park
                                                                                               Triangle, VA




                                               Application for Use of the
                                             Telegraph Road Picnic Pavilion
Your permit will not include the park’s $5.00 per vehicle entrance fee (good for 7 consecutive days) paid upon arrival.
Group Information:
Today’s Date:
Group Leader:                                                            Group Name:
      Sponsor:                                                                # in Group:              (estimate high if unsure)

Address:
                   Street No/PO Box


                   City, State Zip
Phone:                                                                      Fax:


Reservation Information: We will try to accommodate your first choice if possible. Please provide a 2nd choice.
1st Choice:                                                                        to
                                        Arrival Date (mm/dd/yyyy)                                     Departure Date (mm/dd/yyyy)
2nd Choice:                                                                        to
                                        Arrival Date (mm/dd/yyyy)                                      Departure Date (mm/dd/yyyy)
3rd Choice:                                                                        to
                                        Arrival Date (mm/dd/yyyy)                                      Departure Date (mm/dd/yyyy)

Arrival Time:                           AM/PM     Departure Time:                            AM/PM
              No earlier than sunrise                                 No later than sunset


Payment Options: $80.00/day
   Check enclosed                    Mastercard/Visa          American Exp.             Discover           Novus




                                     Credit Card Number               Exp. Date              Authorizing Signature


      Please Note: Pages 1 and 2 of your application must be received by Prince William Forest Park to ensure processing.

                                                       Prince William Forest Park
                                                      Attn: Telegraph Road Pavilion
                                                     18100 Park Headquarters Road
                                                           Triangle, VA 22172
                                                            Fax: 703-221-3258
                                                 Checks payable to National Park Service

                                                                For Official Use Only

Assigned Permit #:                                     Employee Receiving Request                           Date Request Received




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