2018-2019 RAB Equipment Lending Program Contract (Ringette Association Of Burlington)
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2018-2019 RAB Equipment Lending Program Contract
Please complete this form and print before clicking the submit button.
Player Information
This section is for information on the child who will be using the equipment.
Child's full name
*
Is your child new to Ringette and the Association
*
YES
NO
Answer either Yes or No
If NO for above please give first year registered
Acknowledgement of program information
This section verifies you have read and understand the program outlines and obligations/responsibilities
I have read and understand the outline and responsibilities/obligations of entering this program
*
YES
This box must be checked and will constitute agreement
Agreement to Provide Surety and Bond
This surety will be held in bond for the return of equipment in good and useable condition. A cheque in the amount of $400.00, dated Oct.1/18 and made payable to the Ringette Association of Burlington will be given to the Equipment Manager before equipment is released.
I agree to provide bond
*
YES
You must check the box which will constitute agreement.
Acknowledgement of Responsibility
This signifies your acknowledgement that you accept all responsibility for this equipment being loaned to you by the Ringette Association of Burlington as outlined in the program information.
I agree that I am responsible
*
YES
You must check the box and this will constitute agreement
I have been loaned the following pieces of equipment: (to be filled out at time equipment is handed to player)
$ 48 - Helmet
$ 55 - Ringette Mask
$ 45 - Shoulder Pads
$ 25 - Elbow Pads
$ 50 - Gloves
$ 65 - Girdle
$ 35 - Pants
$ 35 - Shin Pads
$ 12 - Neck Guard
$ 45 - Hockey Bag
$ 17 - Ringette Stick
To be filled out at time equipment is handed to player.
Parent/Guardian Information
please complete this information fully.
Parent/Guardian Full Name
*
Parent/Guardian email address
*
Example: you@yourdomain.com
Parent/Guardian Phone number
*
Example: ###-###-####
Signature Block
After printing this form, please provide Parent's / Guardian's signature here:
Parent's / Guardian's signature:
Human Validation
Check The Box
*
Human Validation Failed, Please Try Again
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