Equipment Rental Request Form
Name
*
First Name
Last Name
Organization/Department
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
Requested Rental Dates
*
Pick Up Time
*
Drop Off Time
*
By Completing this form, I agree to the following
*
Equipment will be picked up and dropped off by requesting organization listed above.
Request for pickup will be made 3 days prior to listed pick up date.
Equipment not returned on time will accrue an additional day's rental charge ($75) plus an additional $25 fee per day, until returned.
Requesting organization will be held responsible for any damaged or missing equipment.
Rockingham County Conservation District is not liable for any injuries or damages that occur while equipment is in possession of the requesting organization.
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Amoozemeter Rental
$
75.00
Number of Days Requested
1
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10
Item subtotal:
$
0.00
Submit
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