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Instrument Loan Agreement Form

This document is an instrument loan agreement form used by a school band program. It lists the student's information, the instrument being loaned including any accessories, and notes any existing damages. It also details a rental fee of $50-$100 per student to help offset maintenance costs, though the school will still cover most expenses. The student and parent must sign agreeing to be responsible for any damages or loss of the instrument while it is loaned to the student and to return it in good condition.

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538 views2 pages

Instrument Loan Agreement Form

This document is an instrument loan agreement form used by a school band program. It lists the student's information, the instrument being loaned including any accessories, and notes any existing damages. It also details a rental fee of $50-$100 per student to help offset maintenance costs, though the school will still cover most expenses. The student and parent must sign agreeing to be responsible for any damages or loss of the instrument while it is loaned to the student and to return it in good condition.

Uploaded by

Brian
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd
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Instrument Loan Agreement Form (rev.

6/5/12)

Student Date
Instrument Value
Make Model Serial Number

Received accessories as follows:


Case (serial #) Ligature Mutes (#)

Lyre Cleaning Rod Tuba Slide

Neck Strap Reed Case Extra Slides

Mouthpiece (#) Swab Miscellaneous

Mouthpiece Cap Pegs

(NOTE: Please write on the back of this sheet any damages noted when receiving it.)

There is a rental fee for all musicians who borrow/use a school owned instrument throughout the summer and/or school year.
The fee for the 2014-15 school year is $50 per instrument, not to exceed $100 per student ($25 for non-marching
band/indoor percussion members, and $50 for those that march). This one-time fee will help off-set the total
maintenance expenses of each piece of equipment throughout the year, while still providing a great financial savings to our
families by not having to purchase the instrument.

If the student is a member of the marching band, we will add the rental fee to the student account when the instrument is
signed out and this form is completed and returned. For non-marching students, we ask that you attach a check payable to the
Green Hope High School Band Boosters to this form.

While this fee will provide some relief on our repair and maintenance budget, the band program will still be covering the
majority of the equipment expenses. Please note that damage incurred due to irresponsibility or that was preventable on the
part of the student, will be charged back to the student at the full repair price (in addition to the rental fee). Students are
expected to take care of school instruments the same as if they owned them.

I hereby agree to hold myself responsible for the loss or any damages which may come to this instrument or its accessories
while in my care. I agree that no person will be allowed to use the instrument and that I will return it to the school in as good
condition as when I received it when requested to do so by the director.

Pupil Signature__________________________________________ Date_________________________________

As the parent of student named above, I agree to be responsible for any damage to or loss of the instrument or its accessories
as described above.

Parent Signature_________________________________________ Date_________________________________

Office Use Only


Approved by:______________________________________________ Date:____________________________
Equipment described above loaned out on:__________ Equipment returned on:__________________________
Condition when returned:________________________________________________________________________

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