Membership Application                        

Name____________________________________________Email_________________________________

Address___________________________________________________________Zip__________________

Phone________________________ Date of Birth________________ Are you over 18?     YES  NO

How you found us?______________________________                                            

 I have read and agree to abide by the Station North Tool Library’s Borrowing Policy.

 I especially read the part that said all tool rentals are for one week. That was my favorite part.

 I understand that all late tools incur a $1/day/tool late fee - even days we are closed.  

 I understand that all memberships are for 1 year and the various tiers have been explained to me.

 I understand that memberships are NOT auto-renewing and it is my responsibility to annually renew my continued support of this amazing nonprofit resource that I could not live without.. right?!?

PLEASE SELECT YOUR ANNUAL MEMBERSHIP

Sliding Scale $15 minimum - I would like to pay: $____________  Payment Method____________

$9 x12 Month Auto Debit - so stoked about my FREE Shop Safety I Class!

$19 x12 Month Auto Debit - so stoked about my ONE class pass!

$29 x12 Month Auto Debit - so stoked about my TWO class passes!

$39 x12 Month Auto Debit - so stoked about my THREE class passes!

Drivers License (or Govt ID)  #  __________________________________Issuing State/Agency____________

Emergency Contact __________________________________________Phone___________________________

___________________________________________________________________           _____________________

Signature                                                                              Date

 DID YOU READ AND SIGN THE BACK???                  

Rules to Live By

Tools can only be used by Station North Tool Library members.

Please return them clean.

Report any damage immediately.

Borrowers are responsible for damage they have caused, but we promise not to be angry!

If you feel compelled to return an item in better condition than when you borrowed the tool, we would love you forever. Gold Star for you!

Member Waiver of Indemnification

I, ___________________________________________(print name,) state that I am capable and experienced in using the tools I am borrowing, and that I will use the tools I am borrowing in a proper manner.

I, ___________________________________________(print name,) do hereby for myself, on behalf of my successors and assigns, in consideration of being permitted to borrow tools, waive any and all claims against Station North Tool Library and Fusion Partnerships, its officers, agents, and employees for any injury or injuries of any nature that I may suffer or incur in the use of the tools that I am borrowing from the Station North Tool Library.

I, ___________________________________________(print name,) do hereby for myself, on behalf of my successors and assigns, in consideration of being permitted to borrow tools, agree to release and indemnify and hold harmless Station North Tool Library and Fusion Partnerships, its officers, agents, and employees from any and all liability, loss, claims, and demands, actions or causes of action for the death or injury to any persons and for any property damage suffered or incurred by any person which arises or may arise or be occasioned in any way from the use of tools I am borrowing from the Station North Tool Library. I am aware that SNTL, its partners, directors, officers, members, and employees claim no expertise and make no representation concerning the fitness of any tool for any particular use.

I affirm that the above information is current, true and correct and may be subject to verification. I further state that I have read and fully understand the rules and regulations of the Station North Tool Library and I understand that failure to comply with any of these rules may result in revocation of my borrowing privileges and/or legal action against me. I have read and signed a Waiver and Indemnification form, relinquishing any and all claims against Station North Tool library and Fusion Partnerships, its officers, agents, and employees.

Signature _________________________________________________________Date:________________________