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EQUIPMENT RENTAL FORM <br /> Ad <br /> City Hall,207 Lafayette Street, Suite 105 Today's Date: <br /> W I 507-457-8258 Pick-Up Date: <br /> recreation@ci.winona.mn.us <br /> PARK & RECREATION www.cityofwinona.com Return Date: <br /> Name: Home/Cell Phone: <br /> Group Name: Work Phone: <br /> $1 Per Quantity Below: $5 Per Quantity Below: No Charge: <br /> (Please list quantity of each.) (Please list quantity of each) "This Event is Tobacco Free" <br /> Basketball Badminton Set Yard Signs provided by SHIP-State Wide <br /> Add 2 racquets/birdie$3 (Qty) Health Improvement Partnership. <br /> Football Bingo Set(50 Cards) <br /> Please share a photo of this item on display <br /> Football(Nerf) Add additional cards$3 (Qty) at your event(no images ofpeople)and <br /> Frisbee Bocce Ball send to:recreation@ci.winona.mmus <br /> Kickball <br /> Rubber Play Ball Ladder Ball <br /> Soccer Ball Lawn Darts <br /> Softball(12 inch) Set of Horseshoes(2 pair) <br /> Volleyball � <br /> Tug-of--War Rope ship <br /> Wiffle Bat/Ball Set <br /> statewide health <br /> improvement partnership <br /> $3 Per Quantity Below: $10 Per Quantity Below: <br /> (Please list quantity of each.) (Please list quantity of each.) Nursing Lactation Tent <br /> Gunny Sack(Lots of 5) Bean Bag Board Set A pop-up tent is available for check out that <br /> provides mothers a private place to nurse <br /> Scoops&Ball Set Bullhorn(check size desired) while at community events. <br /> Mini This item is provided by SHIP,the State <br /> Set of Rubber Bases Regular Wide Health Improvement Partnership. <br /> Softball Bat Parachute Please share a photo of this item on display <br /> at your event(no images of people)and <br /> Clown Board/Bag Toss Set Volleyball Set send to: recreaion@ci.winona.mn.us <br /> Turn requests into Park&Recreation at least five(5)business days prior to the listed pick-up date; first come, first serve. <br /> Items returned after the listed return date will incur a late fee equal to the same amount as initial rental fee for each day late. <br /> Fees listed are for one (1) weekday rental, or a weekend rental picking up Friday and returning Monday. To rent for more <br /> than one(1)weekday, the initial rental fee will be applied per each day of rental. <br /> Cancellation Policy: Five(5)working days before the listed pick-up date to receive a refund equal to 50%of the total rental fee. <br /> Lost/Damaged Items: Any and all equipment lost/damaged due to neglect or abuse or otherwise not returned will incur a <br /> replacement fee. The recipient will be responsible for paying 75% of the replacement cost of the item(s) at the time of loss. <br /> I have read the instructions and policies listed above (initials): OFFICE USE ONLY: <br /> Amount Paid: <br /> Signature of Recipient: Method of Payment: <br /> Date Paid: <br /> Park Rec. Staff: <br />