Morale Gear Check-out Form

First Name

Duty Station (if applicable)

Status (AD, Dependent, Retired, Reservist, etc.)

Last Name

Phone Number

Rank (if applicable)

EMPLID

Address

If checking out Kayak or Fishing Pole, please add the assigned number.

Rented Item(s)

Start of Rental

End of Rental

Hold harmless/indemnification Clause

I agree to reimburse, indemnify, and hold harmless the Coast Guard, the Coast Guard MWR program, its agents and COMDTINST 1710.13E 1-3 employees from any and all claims and causes of action that arise or may arise from my (our) use of the Coast Guard MWR equipment or facilities.

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