Please provide the name of the kit you would like to check out: * RequiredDate you need kit: - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Date kit will be returned: - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Borrowed material must be returned the same condition in which it was received. By signing here, you accept responsibility for the replacement or repair, including any associated costs, of any material(s) that became damaged, lost or stolen while in your care.Name: * Required First Last Agreement * Required I am at least 18 years of age I am the above named individual I will hold responsibility for the reserved kitToday’s date: - must be mm/dd/yyyy format * Required Date Format: MM slash DD slash YYYY Phone: * RequiredEmail: * Required School/Program Affiliation: * RequiredCommentsThis field is for validation purposes and should be left unchanged.