Outside Equipment Use Request Form
Fill out this form in full if you would like to receive approval to use individually owned aerial apparatus and rigging hardware at Brass Butterflies in curriculum classes, private/semi-private lessons, rentals, or open gyms.

After submitting the form you will be contacted with next steps for approval or an explanation of why your request is not being approved.

If you have any issues filling out this form, please contact info@brassbutterflies.com
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Email *
What type of equipment are you seeking approval for personal use at Brass Butterflies? *
Required
Please provide details about all of your equipment, including where it was purchased from, and when it was purchased.  Please email proof of purchase documents (PDF or Image files) for your apparatus and any rigging hardware to info@brassbutterflies.com separately. *
Are there any existing safety issues, accidents, damage, wear, or other information concerning your equipment that we should be aware of? *
Are you interested in setting up an apparatus care education appointment with our Aerial Manager? *
By submitting this form, if I am approved to use my own equipment at Brass Butterflies, I agree to abide by the Outside Equipment Use Policy as posted at   https://www.brassbutterflies.com/outside-equipment *
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.
Required
A copy of your responses will be emailed to the address you provided.
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