Equipment Check-out Form

This form assigns primary responsibility for 4-H equipment to the borrower. Equipment should be returned with all the accessories provided in a good condition. If it is determined that loss or damage is a result of negligence, the borrower may be held financially responsible for the repair or replacement of the equipment.
Pick-up Date*

MonthDayYear
Due Date*

MonthDayYear
Full Name:*

First NameLast Name
County/City:*
E-mail:*
Phone Number

Area CodePhone Number
Equipment*

4-H Question WheelBlender BikeBuzzers / BowlCameraiPadsLaptopProjectorSugo Robotics TableSugoBotsLawn Tractor Kit and Track
Additional Information
Signature*

I have read the above information and agree to the terms and conditions herein contained.
Should be Empty: