National Wheelcats Sports Program

Equipment Loan Contract

I,_______________________________________take full responsibility for the equipment named here;

_________________________________________________________________ and agree to return said

equipment in the condition in which I received it with consideration given to normal wear and tear from use such as but not limited to; minor scratches/scrapes, decreased tire tread, worn strapping, stripped screws, etc.

I also agree to assume full financial responsibility for repairs to the above named equipment in the event I

return it with damages other than normal wear and tear (cost to be determined after review and evaluation from

a professional specializing in bicycle repair.) 

Furthermore, should I return the equipment in such a manner, as it is beyond repair I assume full financial

responsibility for the original cost of the equipment in the amount of $_______________ .


I agree to return the equipment at a specified time of I month or at such time as has been agreed upon

and listed by the parties below.

_________________________________________                   ___________________________
National Wheelcats Representative Loan Recipient                          Athlete Loan Recipient

Date equipment needs to returned

My address and phone numbers where I may be reached:

Name: __________________________                                                 Work Phone: _________________

Cell Phone: ______________________                                                 Home Phone: _________________

(Street) _____________________________________________________________________
(City) _______________________       (State) _____    (Zip Code) _______________

E-Mail Address: ________________________________________________

Emergency Contact: ______________________________      Phone Number: __________________


Celebrating over 60 years of providing sport activities for Individuals with physical disabilities