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Equipment Order Form

Available Equipment

The following equipment is available for request. Please download and read the appropriate .PDF file below before making your request to confirm you understand your responsibilities for each type of equipment you have requested. Then place a check mark in the box next to that equipment to request the equipment.

Request Information

 
<December 2014>
SuMoTuWeThFrSa
30123456
78910111213
14151617181920
21222324252627
28293031123
45678910
<December 2014>
SuMoTuWeThFrSa
30123456
78910111213
14151617181920
21222324252627
28293031123
45678910


 
 
 
   
   
   
 
 
City*  
State*
Zip*    
 
 
Event City*  
State*
Zip*    

      

  • to coordinate with NC DOI-OSFM Injury Prevention staff member on picking up or having equipment delivered.
  • that the equipment will be used for its intended purpose in a safe and proper manner.
  • that I have read and printed instructions and requirements for requested equipment.
  • to inspect all equipment in the presence of an NC DOI-OSFM staff member at the time of check-out and check-in, to determine that the equipment is in working order and that nothing is missing or damaged.
  • to return alls equipment in the condition it was received.
  • to either ship item or make arrangements with NC DOI-OSFM Injury Prevention staff member to have item returned within 4 business days.
  • to pay the cost of any piece or part of equipment that is lost, stolen or damaged while the equipment is in my care.
  • to report any damages, defects or problems with equipment that is checked out under my name, when It's returned.