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					                                          The University of Alabama                                            Locker #
                                     University Recreation Aquatic Center
                                           Locker Reservation Form

1.   Member Information: (PLEASE PRINT)

     Name: ________________________________________________                        CWID #: __________________________

     Membership Classification: _______________________________ Email: __________________________________

     Primary Phone #:__________________________________               Alt. Phone #: _________________________________

2.   Locker Reservation Options      3. Location                                                      4. Expiration
       One Year $30.00                  Men’s LR __________           Women’s LR__________               Jan 1
       One Semester $15.00              Men’s Staff LR______           Women’s Staff LR______              May 1
                                                                                                         Sept 1

5. Agreement: Please read the following carefully. All questions concerning locker reservations may be directed to
   Member Services. The University of Alabama and University Recreation grants to the User permission to use the
   Aquatic Center locker indentified above for a specified period of time. The user will consent to the following terms
   and conditions:

     a.   All lockers within University Recreation facilities are the property of the University and are subject to applicable
          University policies. University Recreation reserves the right to alter the policies governing the use of lockers
          with appropriate notice. Misuse of a locker may lead to termination of locker privileges and/or membership.
          User is responsible for any and all damage to the locker during the rental period and will be liable for any cost
          of repair or replacement.
     b.   Locker reservations are non-refundable. Any of the following acts or events shall result in the immediate
          termination of the permissive use herein granted: (a) non-payment of use fee; (b) expiration of this use
          agreement; (c) loss or revocation of privileges for use of facility where the locker is located; (d) misuse or
          damage to the locker or facilities and/or violation of University Recreation policies.
     c.   Your locker reservation will expire on the date provided above. Following the expiration dates, all remaining
          contents will, in accordance with established University Recreation rules, be considered abandoned property
          and disposed of accordingly. If you do not renew or empty the locker, all contents will be removed. University
          Recreation assumes no obligation to store items for you. In order to claim removed locker contents, members
          should visit the Member Services office. A photo ID may be required.
     d.   University Recreation is not responsible for lost or missing items, either before or after clearance of a locker.
          University Recreation will not guarantee the security of the items vacated from lockers. As to any action taken
          by University Recreation, the User agrees that the University, its officers, employees, or agents shall not be
          liable for or guilty of any offense of trespass, theft, unauthorized entry, or conversion or personal property.
     e.   By signing this agreement User acknowledges that she/he has read this agreements and that she/he
          understands and accepts the terms and conditions thereof.

Signature: ______________________________________________________                            Date: _____/_____/_______

                       User Renewal Signature: ____________________ ___________________ _________________
OFFICE USE:                New:                     Renewal:             Renewal:             Renewal:
Receipt No.
Amount Paid
Office Staff

OFFICE USE:       
Locker Reservation Expiration Date:           /          /

User was Notified: 
Primary Phone # called _____________________________    Action___________________________________________ 
Alternate Phone # Called ____________________________  Action___________________________________________ 
Email Address _____________________________________  Action___________________________________________ 
Notice on Locker___________________________________  Action ___________________________________________ 
Other ____________________________________________  Action ___________________________________________ 
Date Contents Cleared:                                                                    Cleared by Whom:  
          /          / 
Date User Claimed Contents:                                                         Photo ID Verified:
          /          / 
Staff Verification:  


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