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Fall Fixit Clinic Registration

Please correct the field(s) marked in red below:

Reduce, Reuse, Repair...Repeat!

Discover the lost art of "Thrift". Experience the empowerment of finding value instead of disposal. Guided Do-it-Yourself disassembly, troubleshooting and repair. Local tinkerers will be on hand to help you figure it all out and hopefully, fix it. 

Fall Fixit Clinic

When: Sunday October, 7th   Noon - 3 pm

Where: Burbank Recycle Center

500 S. Flower St

Burbank  CA 91502

Note: There is no guarantee that your item will be able to be repaired, and in fact, could be made worse. Please keep in mind that this is a community event with well-intended volunteers dedicated to promoting repair. However, there are too many variables to ensure success for every item. If you are concerned about the risk, please do not bring anything of great personal value to you.

(Prior to registering, please make sure you have the item available to answer some important questions.)

1
Name
2
Email
3

What are you bringing? (If a manufactured item, please provide make, model and year)

What are you bringing? (If a manufactured item, please provide make, model and year)
4

What's wrong with it?

(Please provide as much detail as you can about the problem. Did the symptoms manifest gradually or was there an "event"? Can you reproduce the symptoms on a regular basis or is it intermittent?) 

5

Have you tried to fix it? If so, please describe what has been done. (e.g. have you done any web research to see if someone's had a similar problem?):

6

OPTIONAL BUT HELPFUL: What does the item weigh? (in decimal lbs please,  e.g. "3.5 lbs" not "3 lbs 8 oz") This will help us assess our waste stream diversion impact.

7
How did you hear about the Fixit Clinic?
8

Liability Waiver: (You will also be asked to sign a City of Burbank waiver the day of the event)

In consideration for being allowed to participate in the event, I hereby waive, release and forever discharge Fixit Clinic, The City of Burbank, its officers, employees, agents, volunteers and any others acting on their behalf from any and all responsibilities or liability from damages or injuries of any kind to my property, any one else's property, or to me and any other person, in my party or otherwise, as a result of my participation in this event. I hereby grant Fixit Clinic, The City of Burbank and its agents the absolute and irrevocable right and unrestricted permission to use photographs and video taken at the event.

Liability Waiver: (You will also be asked to sign a City of Burbank waiver the day of the event) In consideration for being allowed to participate in the event, I hereby waive, release and forever discharge Fixit Clinic, The City of Burbank, its officers, employees, agents, volunteers and any others acting on their behalf from any and all responsibilities or liability from damages or injuries of any kind to my property, any one else's property, or to me and any other person, in my party or otherwise, as a result of my participation in this event. I hereby grant Fixit Clinic, The City of Burbank and its agents the absolute and irrevocable right and unrestricted permission to use photographs and video taken at the event.
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