OUSD Wellness Spinner Wheel Request Form
By filling out this form, you are accepting responsibility for the OUSD Health & Wellness Spinner Wheel and all agreements listed below:  

1. Ensure you are able to pick up and return the Spinner Wheel (see below for dimensions).
2. Ensure you are able to securely transport and store all parts of the Spinner Wheel and return all pieces with no damage.
3. Ensure you are able to securely lock up and store the Spinner Wheel if you are keeping it overnight.
4. Ensure you are able to thoroughly clean the Spinner Wheel.
5. If Spinner Wheel is returned damaged, you will be responsible for cost of repair.
6. If Spinner Wheel is not returned, you will be responsible for replacing.

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

Spinner Wheel is 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 Spin Wheel - Please note wheel + stand dimensions [The Spinner Wheel is 24 inches wide] [Tall stand is 65.5 inches tall, with a 22 x 21 inch base] [Short stand is 29 inches tall, with a 14 inch wide base]
Name *
Phone Number *
Email *
How would you like to be notified of your confirmation? *
(email preferred)
School or Organization *
Role at School or Organization *
Event / purpose *
How will the Spin Wheel be used to promote Health & Wellness? *
Event Date(s) *
Event Time *
Please enter a start and finish time.
Requested Date of Pick Up *
MM
/
DD
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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.
Will you be picking up the Spinner Wheel yourself? *
Do you want to use the tall or short stand?
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Name of person picking up the Spinner Wheel
Please fill this out if someone other than yourself will be responsible for picking up the Spinner Wheel
Phone number and email of person picking up the Spinner Wheel
Please fill this out if someone other than yourself will be responsible for picking up the Spinner Wheel
I have read the requirements for using the Spinner Wheel at the beginning of this form. *
(Please make sure you review before submitting).
I will use only dry-erase marker or removable tape (masking / "scotch" tape) and NO permanent marker or other stronger tapes (i.e. no duct tape) on the Spinner Wheel. *
Please initial here to accept responsibility for the Spinner Wheel.  If there is damage to the Spinner Wheel or if it is not returned, your organization will be responsible. *
How did you find out about the OUSD Spinner Wheel?
Please share photos of the spin wheel in action with lydia.yamaguchi@ousd.org!
A copy of your responses will be emailed to the address you provided.
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