Birth Product Rental Agreement / Purchase Booking
Book your Birth Pool, TENS or Kaya Stool Rental. If you book more than one Product you will receive a 15% discount!
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Expected Due Date *
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Care Provider *
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Submersible pump, Air pump & Tarp Rental (FREE with pool rental!)
Pool Reservation ($170 alone or save 15% with a package!)
Stool / TENS Reservation (save %15 with a package!)
Add Ons (For purchase)
Place of Pick Up
The following document represents an agreement between Earthside Birth Services (lessor) and (your full name - lessee) *
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Terms Of Agreement
1. Lessee understands that the rental price $170 is on a per birth basis of a period of up to 5 weeks.

2. Lessee acknowledges that this agreement is non-transferrable

3. Lessee acknowledges that the water birth pool rental is specifically limited to indoor use, and is to be used only with the disposable liner provided with the rental. The pool is also limited to use for labour and birth.

4. Lessee agrees to take full responsibility for the manner in and purpose for which said water birth pool is used.

5. Lessee agrees to return the water birth pool to Pomegranate Community Midwives Clinic, or the home based business Earthside Birth Services no later than 14 days after the lessee's expected date of delivery.

6. Lessee agrees to return the water birth pool to lessor clean, dry and undamaged following its use.

7. Lessee agrees to pay for any additional fees up to $100 for the pool being returned dirty, damp, or damaged, or for any damage to the air pump or submersible pump.

8. Lessee agrees to pay any additional fees up to $100 for the pool being returned later than 14 days after the lessee's expected due date

9. Lessee agrees to pay full retail price for the replacement of rented birth pool in the event that it is not returned to the lessor, or redered unusable while in lessee's possession.

10. Lessee understands that there will be no reduction in the rental fees if the water birth pool is unused during the rental period, if the water birth pool is returned before the birth or before the end of the rental period.

11. Lessee understands that the rental fee is nonrefundable, and that no portion of the rental fee will be refunded.

12. Lessee agrees to release and hold harmless lessor and/or any agent thereof, its members, employees, associates, and a-liated manufacturers from any and all responsibility or liability for complications, or injury to any or all persons in connection with the use of rented water birth pool that may occur before, during, and/or after labor and/or birth in the water birth pool.

13. Lessee specifically holds lessor harmless from any claims made by third parties, as well as any damage or injury to property occasioned by the use of the water birth pool during the rental period or while the water birth pool is otherwise in the possession of the lessee 14. All fees must be paid prior to pool pick up.

15. Lessee understands the damage deposit will be refunded once the pool has been returned no
later than 14 days after the lessee's expected date of delivery, and once the pool has been inspected.

I, the undersigned, have read, understand and agree to the terms outlined above. *
***By entering your name and today's date below you are electronically signing this rental agreement***
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