Equipment Loan Form & Agreement

Please complete form and agreement in full. HSC/PL is happy to assist with your need when possible. Once your request is received the info will go through the approval process and when approved you will be notified via email.

Please note the contact info for the HSC/PL Administrator name is below and pickup and drop off times must be arranged directly with him upon approval of this request.

Steve Rempala

- Set of Small Sided Portable Goals (7x21) in goal bags (2 goals = set = 2 bags)
- Set of Full Size Portable Goals (8x24) in goal bags (2 goals = set = 2 bags)
- Flags (1 set=4 flags)
- Turf Flags (1 set = 4)

If so, please provide what size goals may be available and the contact person with contact phone number

As a condition of your agreement to borrow equipment you agree that you have the authority to be a representative of the organization requesting to borrow equipment and agree to the following terms:

- The equipment will be returned in the same condition as it was when borrowed.
- Any damage to the equipment will be noted and the appropriate replacement items will be ordered, paid for and provided to HSC/Penn Legacy within 10 days of return date.
- The replacement parts must be ordered via HSC/PL’s choice of vendor, and must be appropriate and equivalent to the equipment being replaced.
- HSC/Penn Legacy will be copied on all such correspondence and will need to approve the purchase to be sure it is accurate.

Your electronic signature below (after the “s/” below) indicates that you have read this release and waiver, fully understand its terms, and consent to be bound.

Please enter your First and Last Name S/:

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