#MegaColon Request Form

Are you hosting a health fair or colorectal cancer (CRC) awareness event where our giant inflatable colon could help educate your attendees about the importance of screening for CRC? Please confirm you can provide the information below before moving forward with completing this request form. A member of our team will follow-up with confirmation and related details.  

1.   Provide proof of liability insurance.

2.   Donation of $3,000 + processing fees for one day of use. This cost includes covering shipping (FedEx Ground), staff time, and wear-and-tear to the colon. Payment must be received prior to the #MegaColon being shipped to your location. Rental costs are $500 for each additional day. If a generator is needed, the cost is $200.

3.   The #MegaColon must be shipped to a business address with ability to receive the inflatable between 8 a.m. and 5 p.m. weekdays.

4.   Confirm you can return the colon within 2 business days of the event (the Colorectal Cancer Equity Foundation will provide the return shipping label). Please provide as much lead time as possible for your event request, but we need a minimum of (5) weeks between request date and event date.

"*" indicates required fields

Name*
MM slash DD slash YYYY
MM slash DD slash YYYY
Can you provide certificate of insurance with a $1 million general liability insurance with the Colorectal Cancer Equity Foundation listed as an additional insured.*
Max. file size: 192 MB.
Can you kindly consider donating $3,000, which would also cover processing fees for shipping, staff time, and any wear-and-tear associated with the colon? Online payment options, such as ACH or credit card, are available for your convenience. Once your request is approved, a secure payment link will be provided.
Do you have a business address that is capable of receiving the #MegaColon during the hours of 8 a.m. to 5 p.m. on weekdays?
Shipping address: please include the name for the shipping label and phone number.*
Can you arrange for the #MegaColon to be shipped to the provided address within 2 business days of the event? The Colorectal Cancer Equity Foundation will provide a return shipping label.*
Please confirm if your venue can accommodate the following requirements for the colon:*
Please ensure that your venue can meet these specifications. All must be checked.
Please confirm that you and your team will not modify or alter any signage on the colon, including covering or changing informational logos, placements, or signage. Additionally, please note that depending on the #MegaColon schedule and shipping logistics, there may be additional items specifically for Colorectal Cancer Equity Foundation events in the shipping container. It is crucial that these items remain in the container and are returned along with the inflatable colon.*
Please confirm you understand this is a request form only. Our team will process this request and will check the availability and logistics involved and get back to you with confirmation within one week.*
By submitting this rental application, and checking this box, I agree that all the information provided here is accurate, and if the colon is available for my event, I will notify the Colorectal Cancer Equity Foundation immediately should any of these details change. I agree to notify the Colorectal Cancer Equity Foundation of any harm or damage that occurs to the #MegaColon while it is under my care. I will not hold the Colorectal Cancer Equity Foundation liable for any damage to any person or property from use of this inflatable educational tool that occurs while the #MegaColon is in my possession.*
This field is for validation purposes and should be left unchanged.

A copy of your responses will be emailed to the address you provided.