• Equipment Loan Request Form

    Basic Information
  • To request a loan of equipment from the Accessible Equipment Loan Program, please submit this form at least 14 days in advance of to be requested pick-up date. Refer to our Accessible Equipment Loan Program Handbook to learn more about the borrowing process and specifics on equipment.

    Link to Handbook: https://bit.ly/4drNkuS

    Equipment is loaned on a first come, first served basis.

    The program is available for Chicagoland use only.

    All Equipment Loan pick-ups and returns are at the Peggy Notebaert Nature Museum at 2430 N. Cannon Drive.

    Please allow for 3 business days for a response.

    Questions? Email Equip@CulturalAccessCollab.org

  • Format: (000) 000-0000.
  • Is this your first time using the equipment loan program?*
  • Equipment Loan Request Form

    Request Details
  • Accessibility Service(s) Required (you can request multiple)*
  • For Assistive Listening/Audio Description, please select which kit(s) you are requesting.*
  • For Open Captioning, please select which kit(s) you are requesting.*
  • Equipment Loan Request Form

    Pickup & Dropoff Dates
  • If you are borrowing the equipment for a single event day, enter the same date for "First Event Date" and "Final Event Date".

  • First Event Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Final Event Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Pickup must occur on the Thursday or Friday before the first date of your event. 

    Dropoff must occur on the Monday or Tuesday after the final date of your event.

    All pick-ups and returns are at the Peggy Notebaert Nature Museum at 2430 N. Cannon Drive between 11:00am and 3:00pm.

    If you need to pickup or dropoff materials on a different day for any reason, complete this form and immediately email equip@culturalaccesscollab.org with your alternate date request.

  • Pickup Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Dropoff Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Rental Waiver & Release of Liability Form

  • I. Disclaimer

    This Rental Waiver and Release of Liability Form (the “Release”) is, effective as of {date} ("The Effective Date"), made and entered into by and between {organization} located at {organizationAddress} ("the Renter") and the Chicago Cultural Accessibility Consortium (dba Cultural Access Collaborative) in partnership with the Chicago Academy of Sciences/Peggy Notebaert Nature Museum (the “Nature Museum”), located at 2430 N. Cannon Dr., Chicago, IL, 60614.

    II. Acknowlegement

    Renter shall acknowledge use of the equipment with the following phrase:

    Equipment Loaned by Cultural Access Collaborative with special thanks to the Chicago Academy of Sciences/Peggy Notebaert Nature Museum

    This acknowledgement shall appear wherever the accessible offerings are listed (printed or digital), such as:
    ● A printed program insert;
    ● Website listing;
    ● Captioning slide or screen; or
    ● Included in audio description script

    III. Express Assumption of Risk

    Renter hereby agrees that they are renting, operating or using the equipment outlined in the attached Schedule I (the “Equipment”) at their own risk. Renter agrees that they are voluntarily participating in all activities related to the rental, operation or use of the Equipment and assumes all risk of injury, illness, damage or loss that might result, even if the risks are out of the negligence or fault of the Cultural Access Collaborative or the Nature Museum or their employees, agents or volunteers.

    IV. Waiver/Release of Liability

    By the execution of this Release, the Renter agrees that the Cultural Access Collaborative, the Nature Museum, and any employees, agents or volunteers representing or related to Cultural Access Collaborative or the Nature Museum shall not be liable for any damages arising from personal injuries sustained by the Renter or anyone under the Renter’s custody, care, and control, as a result of any and all activities related to the rental, operation or use of the Equipment provided by Cultural Access Collaborative. The Renter assumes full responsibility for: (a) any damage that may occur to the Equipment during the Rental Period (including transport of the Equipment), and (b) any such injuries or damages that may occur to any person through the use of the Equipment during the Rental Period, as defined below, and further agrees that Cultural Access Collaborative and the Nature Museum shall not be liable for any loss or theft of the Equipment for the duration of the Rental Period, as defined below. The Renter specifically agrees that Cultural Access Collaborative and the Nature Museum shall not be responsible for such injuries, loss or theft, even in the event of negligence or fault by Cultural Access Collaborative, the Nature Museum, and any of their employees, agents or volunteers representing or related to Cultural Access Collaborative and the Nature Museum whether such negligence is present at the signing of this Release. For the removal of doubt, the Renter hereby agrees to fully release both the Cultural Access Collaborative and the Nature Museum and their employees, agents or volunteers from liability and hold Cultural Access Collaborative and the Nature Museum and their employees, agents or volunteers harmless to any claims related to the Equipment that arise from the Renter’s use of the Equipment during the Rental Period.

    V. Term

    The rental period for the Equipment is from the Effective Date to {dropoffDate} ("The Rental Period") Renter is responsible for picking up the Equipment and returning it to the Nature Museum at the end of the Rental Period unless otherwise agreed to by both parties. Renter agrees to return the Equipment to the Nature Museum in the same condition that the Equipment was at the Effective Date.

    VI. Fees

    There is no charge for the rental of the Equipment; however, in the event that the Equipment is lost or destroyed during the Rental Period, Renter agrees to replace the Equipment at their own expense. Also, if the Equipment is damaged during the Rental Period, Renter agrees to pay for Equipment repair or replacement, as reasonably determined by Cultural Access Collaborative and the Nature Museum.

    VII. Liability to Third Parties

    The Renter hereby agrees that they will indemnify and hold harmless the Cultural Access Collaborative and the Nature Museum and their employees, agents or volunteers for all personal injuries, property damages, or any other damages to any and all third parties, including, but not limited to, operators of the Equipment during the Rental Period that results from any and all activities related to the rental, operation, or use of Equipment during the Rental Period, even if such damages arise out of the negligence or fault of Cultural Access Collaborative or the Nature Museum or their employees, agents or volunteers.

    VIII. Acknowledgement of Release

    Renter states that they have had sufficient time to review this Release and to ask any questions associated with this Release. Renter further states that they have carefully read the foregoing Waiver and Release of Liability, knows the contents thereof, and has signed this Release as their own free act. Renter further warrants that they are fully aware that they are waiving any right they may have to bring a legal action to assert a claim against Cultural Access Collaborative or the Nature Museum for negligence on the part of the Cultural Access Collaborative or the Nature Museum or their employees, agents or volunteers.

    IX. Governing Laws & Consent to Jurisdiction

    All matters arising out of relating to this Release shall be governed by and construed in accordance with the internal laws of the State of Illinois without giving effect to any choice or conflict of law provision or rule (whether of the State of Illinois or any other jurisdiction). Any claim or cause of action arising under this Release may be brought only in the federal and state courts located in Cook County, Illinois and Cultural Access Collaborative, the Nature Museum, and the Renter consent to the exclusive jurisdiction of such courts.

  • I am an Authorized Signer for this organization.*
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: