Clicker Checkout Form

Please enter the information below to request use of clickers.
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    Must be a valid email address
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    You have to enter a number between 1 and 200
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    DISCLAIMER

    Please note that by completing this form that you are placing an official request for the use of COPH clickers and receivers. Upon approval of this request and receipt of the clickers, you retain full responsibility and must ensure that the clickers and receiver are returned in the same condition in which they were received. You will be held accountable for any lost or damaged clickers or receivers.
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