Instrument Loan Agreement Student Name(Required)Period(Required)Period1234567Address Street Address City ZIP / Postal Code Parent Email(Required) Parent Phone(Required)Type of Instrument(Required)Case Number(Required)Consent(Required) I agree(Required)The student and their parents or guardians are responsible for returning the instrument and all of its parts and accessories to the school in the same condition that it was received.Consent(Required) I agree(Required)All dents, scratches, and additional repairs needed for the instrument will be the responsibility of the family to pay for. Repairs need to be done by Halpin Music or John Schad and go through the band office.Consent(Required) I agree(Required)The instrument is not to be played by anyone other than the student who has borrowed it.Consent(Required) I agree(Required)Mouthpieces must be stored in the proper storage area in the case. (Do not leave it in the horn, floating in the case, etc.)Consent(Required) I agree(Required)Instruments must be stored in the case, and the case must be latched and secured at all times.Consent(Required) I agree(Required)Gloves (without grips) must be worn when handling brass instruments. Consent(Required) I agree(Required)The Director reserves the right to deny any student the privilege of borrowing an instrument if the student has previously failed to uphold the terms of this agreement if the student has not handled the instrument properly while in class, or if the student has not shown the responsibility to protect the instrument while in their care. Consent(Required) I agree(Required)If the instrument is stolen, or if the student has lost the instrument or parts of it, they and their family are fully responsible for reimbursing the school for its loss. Please SignPlease sign below to show that you understand and agree to the terms of the agreement, approved by OTHS band staff and administrationParent Signature(Required)Parent SignatureStudent Signature(Required)Student SignatureParent Name(Required)Student Name(Required)Date(Required) MM slash DD slash YYYY Δ