A wooden platform with 3 round holes and colorful round pegs to be hammered into the holes
I hereby acknowledge receipt of the above item(s) from the Adaptive Technologies Lending Library loaned to me by REACH Services for the applicant’s sole use, and that of their clients, of this equipment. These items will not be loaned to anyone else. I acknowledge that this equipment will be used as it is designed to be used and that I will exercise ordinary and reasonable care thereof.
By completing this transaction I acknowledge that:
- I have examined the equipment and that I find it in good condition and fit for its intended use.
- I promise to return the equipment by the date listed above.
- In consideration of future borrowers, I promise to clean and sanitize the equipment prior to returning it.
I understand that this loaned equipment remains the property of REACH Service and is available to me at no cost. In accordance with the laws of the state of Indiana, I hereby forever release and hold harmless REACH Services and its employees or agents from all liability, claims, demands, and actions that I may have for any injury to my person or my property. or that of my clients, that results from the use of the loaned equipment and therefore they will not be held responsible for any defect in the equipment or any accident or injury that may occur during or subsequent to the use of the equipment. I hereby waive any and all claims I may have against the aforesaid related to the use of the equipment.