University of Richmond

SPORT CLUB EQUIPMENT CHECK-OUT FORM

Club Name:          ______________________________________          Date: _________________

Club Contact:          ____________________________________          E-mail: ________________

Campus Address: ______________________________________          Phone: ________________

Equipment Requested (Please circle all that apply):

          Emergency Cell Phone               Hand-held radios          Digital Camera

          Event Tent (10’x10’)                     Field Liner              Battery Charger

Date Requested: ________________________          Pick-up Time: ____________________

Date to be Returned: _____________________          Return Time: _____________________

Purpose for Checkout ________________________________________________________

_________________________________________________________________________

EQUIPMENT GUIDELINES:

• Equipment may only be checked out for Sport Club use.
• Lost or damaged parts will be charged to individual responsible.
• Equipment must be picked up and returned when scheduled.  Clubs will automatically be charged a $5.00 per day late fee.
• Equipment must be reserved 48 hours in advance.
• Do not return equipment without having this form signed by the Campus Recreation Director or Sport Club Coordinator.  Failure to do this may result in charged for missing parts or damages.

I, ________________________, agree that all of the equipment is included and I understand the guidelines for use of the camcorder. I will be responsible for any lost or damaged parts. I understand that failure to follow these guidelines may result in our organizations loss of privileges to use this equipment or automatic charges.

Club Signature: _______________________________________     Date: ____________

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For Office Use Only

Do not return equipment without having this form signed by the Campus Recreation Director or Sport Club Coordinator.  Failure to do this may result in charged for missing parts or damages.

Date returned: _____________        Time: _________________            All Equipment?  Y   N

Comments:

Signature: __________________________________________________          Date: _____ 

                               (Campus Recreation Staff)