Wireless Microphone Request, Waiver & Release

Wireless Microphone Request, Waiver & Release
I understand and confirm by signing this WAIVER AND RELEASE that if any of the equipment below that I use is lost or damaged, I am responsible for replacement costs:
- Rode Wireless Microphones - $320
- Lavalier Microphone - $140
- Connector cable - $30
Name*

First NameLast Name
Email*
example@example.com
Equipment to be checked out:*
Date of Reservation*
Time out:*
Expected time in:*
Should be Empty: