OUSD Bike Blender Request Form
By filling out this form, you are accepting responsibility for the bike blender and all agreements listed below:  

1. Ensure you are able to pick up and return the Bike Blender. A truck or SUV or hatchback car is recommended for transporting the Bike Blender, but if your car can fit a large kids bike without any disassembling, it may fit in your car.
2. Ensure you are prepared to supply ingredients and serving tools (e.g. cups).
3. Ensure you are able to thoroughly clean (1) the bike itself, (2) any supplies you borrow and (3) blender pitchers with soap and water before returning the bike and supplies.
4. Ensure you are able to securely lock up and store the Bike Blender if you are keeping it overnight.
5. If Bike is returned damaged, you will be responsible for cost of repair.
6. If Bike is not returned, you will be responsible for replacing.
7. OUSD is not responsible for any injuries or impacts sustained by use of the bike blender.

Our pick up & return location is: 2850 West St, Oakland, CA. (Suggested: Enter at the gate on 29th St)

Bikes are available on a first-come first-serve basis.
*If you have not received a phone or email confirmation in 3 business days, please email lydia.yamaguchi@ousd.org.

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Email *
OUSD Bike Blender (stand detaches for transportation)
Name *
Phone Number *
Email *
I understand this will be confirmed via Google Calendar invitation to the email provided *
(email preferred)
Required
School or Organization *
Role at School or Organization *
Event *
What will the bike blender be used for? *
Check all that apply.
Required
What will the bike blender be used for? (additional description) *
Event Date(s) *
Event Time *
Please enter a start and finish time.
Requested Date of Pick Up *
MM
/
DD
/
YYYY
Requested Time of Pick Up *
Please write a specific hour, such as 10am.  Normal pick up hours are Monday to Friday, 8:30 am to 4:30 pm but sometimes other arrangements can be made.
Requested Date of Return *
MM
/
DD
/
YYYY
Requested Time of Return *
Please write a specific hour, such as 10am.  Normal pick up hours are Monday to Friday, 8:30 am to 4:30 pm but sometimes other arrangements can be made.
Which bike would you prefer? *
Required
Will you be picking up the Bike Blender yourself? *
Name of person picking up the Bike Blender
Please fill this out if someone other than yourself will be responsible for picking up the Bike Blender
Phone number and email of person picking up the Bike Blender
Please fill this out if someone other than yourself will be responsible for picking up the Bike Blender
Additional supplies you are requesting:
Please check all that apply.
I have read the requirements for using the bike blender at the beginning of this form. *
(Please make sure you review before submitting).
Please initial here to accept responsibility for the bike blender use of the bike blender.  If there is damage to the bike or if it is not returned, your organization will be responsible. *
How did you find out about the OUSD Bike Blender?
Please share photos of the bike blender in action with lydia.yamaguchi@ousd.org!
A copy of your responses will be emailed to the address you provided.
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