CPR Equipment Rental Application Interest Form

CPR Equipment Rental Application Interest Form
Rental Information
The Lessee must be aligned with RN CPR as a certified instructor to rent the equipment. Proof of alignment must be provided at the time of renting the equipment.
- A refundable security deposit of $100 is required at the time of pickup.
- The deposit will be returned upon inspection of the equipment, provided it is returned clean, undamaged, and on time.
- A late fee of $20 per hour will be charged for equipment not returned within the 24-hour rental period.
- The Lessee is fully responsible for any damage or loss of the equipment during the rental period.
- Replacement costs are as follows:
  - Adult Manikin: $200
  - Infant Manikin: $180
  - AED Trainer: $150
- A valid credit or debit card must be placed on file at the time of rental. If the equipment is not returned within 5 days of the agreed return date, the full replacement cost of the unreturned equipment will be charged to the card on file. This is on top of any applicable late fees.
A rental agreement will be signed at time of rental
I agree to the terms stated above

Yes, and I am willing to sign a rental agreementI have a few questionsNo
My Products
prevnext( X )
One Adult Manikin Rental fee is 30 per day, lungs available on request.
$30.00



One Infant Manikin Rental fee is 25 per day, lungs available on request.
$25.00



One AED trainerRental fee is 15 per day
$15.00



CPR supply bundle Rental fee is 60 per day, includes one adult, one infant and one AED. lungs available on request.
$60.00



Total

$0.00
Rental request date

MonthDayYear
Date
The date requested is not guaranteed and will be given in a first come first serve basis

I understandI do not understand, and I will not get my date or be able to rent with RN CPR.
Rental Application
Name of Applicant

First NameLast Name
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com
Are you aligned with RN CPR

YesNo
Agreement
Signature

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Date Signed

MonthDayYear
Date
Should be Empty:

CPR Equipment Rental Application Interest Form

Rental Information

Rental Application

Agreement