Text only, please use form furnished by staff.
I. ____________________ . state that I am capable and experienced in the use of the tools that I am borrowing. that I will use the tools for their intended purpose in a safe and proper manner. that I will not modify the tools in any way, and that I will not allow any other person to use the tools that I am borrowing. I have inspected each borrowed tool and accept its condition. have noted all damage or defects. and advised the lender of my findings.
I do hereby for myself. on behalf of my successors and my assigns. in consideration of being permitted to borrow the tools. waive all claims against Ashtabula County District Library (ACDL) for any injuries. illnesses. or damages of any nature that I may suffer or incur in the use of the tools that I am borrowing from Ashtabula County District library (ACDL).
I do hereby for myself. on behalf of my successors and my assigns. in consideration of being permitted to borrow the tools. agree to release and indemnify and hold harmless Ashtabula County District library (ACDL) and its officers. agents. and employees from any and all liability. loss. claims. and demands. actions or causes of actions for the death or injury to any persons and for damages to property suffered or incurred by any person which arises or may arise or be occasioned in any way from the use of tools I am borrowing from Ashtabula County District Library (ACDL).
Name of Borrower: _______________________________________________________________
Address: _______________________________________________________________________
Phone (home. work. cell): __________________________________________________________
Signature of Borrower: _____________________________________________ Date: __________
Signature of Witness: ______________________________________________ Date: __________
Photo ID: _______________________________________________________________________