Loan Agreement for LUMC Equipment

Name

Today's Date:

Date Equipment will be needed:

When Items will be returned

Purpose of Event/Group name

Number of Tables Needed

Table Payment ($5 per table - leave blank if writing a check)

Number of Chairs Needed

Chair Payment ($1 per chair - leave blank if writing a check)

Responsible Person

This address will receive a confirmation email

Phone

Address of Person Responsible

Address where tables/chairs will be used (if different)

A member of our office staff will contact you to confirm if tables and chairs are available for your requested date. If they are not available, a refund will be issued. By submitting this form, you understand that you are responsible for arranging a pick up and drop off time in coordination with office staff, and that you are responsible for loading and unloading. You understand that any damaged items must be paid for in full, above and beyond the amount of this rental agreement.

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Please fill out this form and click submit to request Linworth UMC's equipment for your group or event. This request will be submitted to our Office Staff, who will be in touch with you shortly.

Loan Agreement for LUMC Equipment

Description

Please Fix the Following