Curry County Voices Equipment Check-Out Form
This Form must be completed by a Curry County Voices Mentor for every checkout.
Email address *
Today's Date *
MM
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Name *
Your answer
Phone Number *
Your answer
Physical Address *
Your answer
Kit Number *
Kit Color *
Kit Description *
Replacement Cost *
Check-Out Date *
MM
/
DD
/
YYYY
Expected Check-In Date *
MM
/
DD
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YYYY
Items Checked Out to Member *
Yes
No
Not Applicable
JVC Camera
Camera Case
Camera Handle
Camera Batteries (X2)
Camera Battery Charger
Camera Power Adapter
Camera Manual
Lens Cap
Shotgun Mic
Hot Shoe Riser
Movo Lavaliere Mics (X2)
Movo Lavaliere Transmitters (X2)
Movo Lavaliere Receivers
Movo Lavaliere Case
Movo Lavaliere Cables
Movo Lavaliere Manual
Tripod Base
Tripod Plate
Tripod Bag
Tripod Arms (X2)
GVM Light (X3)
Light Stands (X3)
Light Kit Batteries (X6)
Light Kit Battery Chargers (X3)
Light Kit Barn Doors (X3)
Light Kit Diffusion Plates (X3)
Member agrees to the terms and conditions on their Master Promissory Note with Curry County Voices and the accuracy of this form. *
Mentor who performed this Checkout. *
A copy of your responses will be emailed to the address you provided.
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