Impaired Vision Goggles Checkout Form
1. The goggles must be returned to the Kansas Traffic Safety Resource Office within 3 business days after the event.
2. Return the goggles with the pre-paid USP label.
3. The individual/organization named on this loan agreement is responsible for damage to and/or loss of the contents. While the contents are in your possession, it is recommended that they are insured for their replacement value of $900.
4. Please make sure all goggles are put back in their respective protective bags. Each kit has 6 different goggles.