Outreach Equipment Request

First Name

Last Name

Church Name

Phone

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Outreach Information

Type of Outreach

Select a date

Location Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Equipment Request Information

No delivery service offered.

Pick Up Date

Return Date

Time

Choose a time

Time

Choose a time

Equipment Available

Upload a list of A/V equipment you are reqeusting, i.e. screens, speakers, projectors, sound board, etc.

Upload File

Use of Equipment

User agrees to use the equipment safely and only in the manner for which it is intended to be used. Owner is not responsible for any personal injury or property damage resulting from any misuse of equipment. User will indemnify and defend Owner from and against any injury damage claims arising out of any misuse of the equipment.

Your Signature

Damage or Loss

User will return the equipment in good condition. If the equipment is damaged or lost while in User's possession, User will be responsible for the cost of the repair, up to the current value of the equipment.