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Get AbleCloset Agreement to Borrow Equipment Release of Liability

Agreement to Borrow Equipment Release of Liability am borrowing the following equipment the I Equipment from AbleCloset a California non-profit corporation to. I The rental period for my Equipment is from understand that it is my responsibility to pick up the Equipment and to return it to the same location at the end of my rental period unless otherwise agreed by both parties. I agree to return the Equipment to AbleCloset in the same condition that it was in on the day I rented it normal wear and tear excepted* However in the event that the Equipment is lost or destroyed during my rental period I agree to replace the Equipment at my own expense. Also if the Equipment is damaged during my rental period I agree to have the Equipment fixed or replaced* If I do not repair or replace the Equipment within 30 days after my rental period I authorize AbleCloset to charge my credit card as described below. My credit card is not authorized for any other purpose. use or for any particular person and that I am solely responsible for the selection of the Equipment. I have consulted with my child s therapist in the selection of the Equipment and have made arrangements with them to check the safety and sizing of I HEREBY RELEASE FROM LIABILITY AND AGREE TO INDEMNIFY AND HOLD HARMLESS ABLECLOSET AND ANY OF ITS EMPLOYEES AGENTS OR VOLUNTEERS REPRESENTING OR RELATED TO ABLECLOSET FOR ANY LIABILITY IN CONNECTION WITH THE USE OR POSSESSION OF THE EQUIPMENT. THIS RELEASE IS FOR ANY AND ALL LIABILITY FOR PERSONAL INJURIES INCLUDING DEATH AND PROPERTY LOSSES OR DAMAGE OCCASIONED BY OR IN CONNECTION WITH THE POSSESSION OR USE OF THE EQUIPMENT. Signature Print Name Date Type of Credit Card circle one Visa MasterCard Credit Card No* Exp* Date. Security Code. Name on Credit Card. Amount replacement cost of equipment Signature of Cardholder American Express. I The rental period for my Equipment is from understand that it is my responsibility to pick up the Equipment and to return it to the same location at the end of my rental period unless otherwise agreed by both parties. I agree to return the Equipment to AbleCloset in the same condition that it was in on the day I rented it normal wear and tear excepted* However in the event that the Equipment is lost or destroyed during my rental period I agree to replace the Equipment at my own expense. I agree to return the Equipment to AbleCloset in the same condition that it was in on the day I rented it normal wear and tear excepted* However in the event that the Equipment is lost or destroyed during my rental period I agree to replace the Equipment at my own expense. Also if the Equipment is damaged during my rental period I agree to have the Equipment fixed or replaced* If I do not repair or replace the Equipment within 30 days after my rental period I authorize AbleCloset to charge my credit card as described below. Also if the Equipment is damaged during my rental period I agree to have the Equipment fixed or replaced* If I do not repair or replace the Equipment within 30 days after my rental period I authorize AbleCloset to charge my credit card as described below. My credit card is not authorized for any other purpose. use or for any particular person and that I am solely responsible for the selection of the Equipment. .

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