I agree to accept full responsibility and liability for all video tapes, DVD or other media and equipment. I understand that damaged, lost or stolen will be assessed at replacement cost, and late returns will be assessed one (1) week’s charges for each full of partial week delinquent. I also agree to rewind all tapes. (Failure to promptly return leased property may result in criminal prosecution)

Signature_______________________________________________ Date____________________

Enclose a photocopy of your drivers license enlarged to 150%-200%

For Institutional members - Complete continue below and include drivers license copies as required above

I, the above signed, authorize the following to use my membership to rent available media & equipment:

1._______________________
2._______________________
3._______________________

Fax or Phone: (206) 903-9010
E-mail to: bobshay@msn.com