AMSEA Display Check-Out Form

Promote cold water safety and survival in your community with an educational display at your health fair or other event. Displays are also useful in the classroom.

AMSEA currently has five cold water safety and survival displays available for loan. The table top displays fold flat for shipping and are easily assembled to fit on a 5-foot by 3-foot surface. Each display focuses on a different aspect of cold water safety and survival. Give-away brochures and past issues of the AMSEA's newsletter, Marine Safety Update, are included with all displays.

Because of the high demand for these displays, they are available for loan only to AMSEA-trained instructors and to Alaska educators or health professionals.

Individuals may not borrow more than one display a time.

Please read all information, instructions and display loan terms on this page before placing an order for an educational display.

To borrow one of AMSEA's educational displays, fill in your name, contact information, and information about your upcoming training. Also, you must read the AMSEA Display Loan Terms and indicate your acceptance of them. In the list of dislplays, below, check the box below the picture and next to the description of the display you'd like to borrow. Finally, click the "Submit Form" button at the bottom of the page.

Once we receive your request, we will confirm availability by e-mail or phone and ship the display to you. You are responsible for shipping it back to AMSEA at your expense.

If you have questions about AMSEA's educational displays, please send an email to AMSEA's Gear Department.

Required fields are in bold text and marked with a red asterisk (*).

Your full name*:

Email address*:

Phone number*:

Mailing address*:

City, State, Zip:*

Shipping address (if different)*:

Preferred method of shipping (if known):

Display is needed on location by*: (date)

Display will be returned by*: (date)

Purpose/Event:

Number of people expected at event:

Comments:

Please read the following AMSEA Display Loan Terms and indicate your acceptance of them by checking the box below.

PLEASE NOTE: As a borrower, YOU (and no one else) are responsible for returning the display that you borrow in the same condition as you received it.

AMSEA's displays see a great deal of use throughout the year. In order to ensure their long life and availability to others, AMSEA requires you to agree to the following terms prior to borrowing a display.

AMSEA Display Loan Terms

By checking the box below, I agree to:

• Request a display with as much advance notice as possible, realizing that displays are loaned on a first-come, first-served basis.
• Maintain physical control of the borrowed items at all times.
• Report any damaged or defective items to AMSEA as soon as possible, regardless of cause.
• Contact AMSEA to request an extension if the display will be held longer than expected, understanding that a late fee may be charged for unapproved late returns.
• Return the display to AMSEA packaged as it was received.
• Ship the display back to AMSEA within 24 hours after use or at the first available opportunity for shipping.
• If I fail to return any items borrowed from AMSEA more than 30 days past date due, I am liable for replacement costs.
• INSURE the display with the return shipper (AMSEA will provide the value).
• Pay for return postage/shipping and insurance.

I acknowledge I have read and agree to AMSEA's Display Loan Terms.*

AMSEA Educational Displays

	Ready for a Safe Boat Trip: A fun, interactive display for children. A simple game covers items that should be included on any boating trip. Participants must match the name of an item to the item in a photograph using ribbons and velcro. This display is best used with an adult helper. Appropriate for ages 4 through 9.
	Personal Flotation Devices . . . Alaskans Just Gotta Wear 'em: An interactive display. Discusses the importance of using a personal flotation device (PFD), the different types, the pros and cons of different PFDs are, and how to choose the best PFD for you. Appropriate for age 8 (with assistance) through adult.
	The Sober Truth About Alcohol & Boating: A colorful, interactive display. Discusses how alcohol affects a person's ability to function (judgement, reaction time, balance) and how alcohol use while boating multiplies the effects of boating stressors and hypothermia. Appropriate for age 12 through adult.
	Seven Steps to Survival: Outlines the Seven Steps to Survival (recognition, inventory, shelter, signals, water, food, play) with photographic examples and brief narratives. Important information for both recreational boaters and commercial mariners. Appropriate for age 12 through adult.
	Commercial Fishing Safety: Shows the different skills learned in AMSEA's hands-on training course, "Marine Survival Equipment, Procedures and Onboard Drills." Appropriate for all ages in communities with a commercial fishing industry. The display is one way to promote fishing vessel safety training.

Did you read AMSEA'S DISPLAY LOAN TERMS and check the agreement box? You must do so before submitting this form.

You will receive an order confirmation within 5 working days. If you do not, please email or phone AMSEA's Gear Department to confirm that we have received your order. Thank you.